10/01/19

2019 Patient-Centered Primary Care

Collaborative Learning Opportunitiese-Catalog

The spirit of learning and collaboration is the spark that can ignite powerful change. To help you adopt a patient-centered care model and fulfill participation requirements under Patient-Centered primary care, we offer a wide range of learning opportunities that are designed to inform, inspire and support you.

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2019 National Collaborative Learning Webinar CalendarFrom this page:

○ Full event descriptions are available by clicking the event title below ○ To register for an event from this page, click the event date below

recording Depression and Anxiety Disorders: Impact, Screening and Treatment CME credits: 1.0

recording Medicare Risk Adjustment Documentation and Coding Guidance: Red Flag HCCs, Part 1

recording Alcohol Use Disorder: Practical Tips for Identification and Management in Primary Care

CME credits: 1.0

recording Using eConsult to Improve Access to Specialty Care

recording Medicare Risk Adjustment Documentation and Coding Guidance: Red Flag HCCs, Part 2

recording Opioid Use Disorder 101

recording Bringing Value with Patient Self-Management Support

recording How an EPHC Organization Manages Chronic Conditions Using Care Optimization and Continuous Quality Improvement to Improve Outcomes

recording Medicare Risk Adjustment Documentation and Coding Guidance: Opioids and More – Substance Abuse and Dependence

recording Supporting Care Planning and Coordination in Primary Care

recording Strategies to Improve Adherence and Medication Reconciliation

recording Medicare Risk Adjustment Documentation and Coding Guidance: Acute, Chronic and Status Conditions

recording Influencing Better Health: An Overview of the Current and Future State of Social Determinants of Health

recording Implementing Motivational Interviewing to Promote Behavior Change: A Practice’s Perspective

recording Medicare Risk Adjustment Documentation and Coding Guidance: Diabetes Mellitus and Other Metabolic Disorders

October 10, 2019 Improving Access to Care in the Medical Neighborhood

November 14, 2019 Utilizing Care Compacts to Enhance the Value of Specialty Referrals

November 27, 2019 Medicare Risk Adjustment Documentation and Coding Guidance: Behavioral Health

CME credits: 1.0

Program Enhancements for 2019 ○ A collaborative learning online resource

library where event materials can now be accessed from your online EPHC Provider Toolkit

Collaborative Learning Recordings ○ Recordings of past events are available

to you 24/7 to accommodate your busy schedule

Did you register for an event and your practice firewall blocked the calendar invitation?

Don’t worry! All of our Collaborative Learning events use the same Adobe Connect meeting room URL.

Just block out the event time on your calendar and save this URL for easy access the day of the webinar.

https://antheminc.cosocloud.com/rgfcc49vhxyw/

CANCELED

Program Enhancements for 2019 | Collaborative Learning Recordings | Back to Calendar3

Collaborative Learning for Value-Based Contract SuccessWelcome to another year of Collaborative Learning. Your success in the Patient-Centered Primary Care Program is

important to us. Therefore, we have prepared an educational program for 2019 that is based on your responses to our mid-year survey identifying your educational needs.

To begin, we suggest taking the following steps to support your program success:

○ Optimize practice performance by focusing on the key elements of the Quadruple Aim: Improved Patient Experience, Improved Population Health Management, Reduced Cost of Care, and Clinician and Staff Satisfaction and Well-being

○ View our recording “Clinician and Staff Satisfaction and Well Being under the Quadruple Aim” and take steps to ensure your practice is proactive against burnout

○ Implement practice standards that meet/exceed the parameters put in place by all payers so you can be sure you are meeting the expectations of all your value based programs

○ Get to know your scorecard and identify areas where practice improvement is needed using the scorecard metrics as your guide

○ Identify practice goals and make small changes throughout the year to help you reach your goals ○ Register for all 2019 learning events at once to secure your spot for these highly anticipated events

Program Enhancements for 2019 | Collaborative Learning Recordings | Back to Calendar4

The following guideline may also be useful when structuring your organization.

Practice InfrastructureCreate a strong practice infrastructure that promotes a healthy workplace environment

Implementing a strong infrastructure will help support the patient care processes you put in place while creating efficiency that will reduce your levels of stress and workplace burnout. These are some suggestions for building a practice infrastructure in a way that will support scorecard success:

○ Hire Care Managers, sometimes known as Case Managers, to review patient data and charts while focusing on closing care gaps

○ Centralize a call center and implement patient registries ○ Implement data mining to understand your patient population and gaps in care ○ Implement a Care Transitions program focusing on reducing readmissions ○ Implement patient outreach and engagement to improve scheduling of well visits ○ Institute practice huddles and meetings

Collaborative Learning Recording

○ How-to Succeed in Value-Based Payment Arrangements ○ Managing Chronic Conditions Using Care Optimization

Documentation Best PracticesEducate practice staff on documentation and coding procedures

Thorough documentation and coding is important for health plans and providers as it:

○ Assures all of a patient’s medical conditions are addressed ○ Improves communication between physicians, hospitals and other health care professionals ○ Provides accurate risk profile development

Documentation is key. If conditions are not documented, they cannot be coded.

Learning events that cover diagnosis coding and documentation best practices through the exploration of case studies and ICD-10-CM coding examples are held throughout the year.

Monthly Medicare Risk Adjustment and Documentation Guidance webinars

August 7, 2019 — September 4, 2019 — October 2, 2019 — November 6, 2019 — December 4, 2019

Risk Adjustment Documentation and Coding Guidance recordings

○ Opiods and more - Substance Abuse and Dependence ○ Red Flag HCCs, Part 1 ○ Red Flag HCCs, Part 2 ○ Acute, Chronic and Status Conditions ○ Cardiovascular Conditions ○ Vascular Disease ○ Respiratory Disease ○ Diabetes ○ Dependency

Disclaimer: This training is based on coding guidance from the Official ICD-10-CM Coding Guidelines, American Hospital Association’s (AHA) Coding Clinic, and/or Centers for Medicare and Medicaid Services (CMS) guidance and guidelines. As the ICD-10-CM code set is updated annually, coding requirements and standards are subject to change, potentially impacting the accuracy of the content contained within this presentation.

Program Enhancements for 2019 | Collaborative Learning Recordings | Back to Calendar5

Reducing CostsTarget cost reductions while maintaining a high standard of quality care

High quality patient care can be delivered at reduced cost if point of service options and patient experience are used to drive health care spending decisions. The following recommendations will educate your practice to make informed health care services decisions.

Collaborative Learning Recordings

○ Resource Allocation Strategies for Potentially Preventable ER Visits ○ Enhanced Personal Health Care Strategies for Reducing Cost of Care

Care ManagementImplement Chronic Care Management processes

Chronic Care Management is critical for delivering high quality, comprehensive patient care. This includes pre- and post-visit chart review, closing identified gaps in care, medication adherence and reconciliation procedures, and the management of high-risk patients.

Consider training practice staff on Motivational Interviewing techniques and having end-of-life discussions with patients.

Collaborative Learning Recordings

○ Supporting Care Planning and Coordination in Primary Care ○ Integrating Clinical Pharmacists to Provide Comprehensive Medication Management ○ Implementing Practice Based Care Management – How InterMed (an EPHC multi-specialty physician owned

organization in Maine) Rocks Their Utilization Targets ○ Care Planning and Coordination: Managing Complex Pediatric Patients ○ Motivational Interviewing in Primary Care ○ Advance Care Planning and End-of-Life Care Discussions ○ Primary Care Practice Roundtable: Utilizing Team-Based Care to Close Care Gaps ○ Care Coordination Strategies to Support Effective Transitions of Care ○ Primary Care Practice Roundtable: Closing Gaps in Care and Completing Annual Visits

WorkflowsImplement Practice Workflows for Population Health Management

Good population health management requires customized workflows that target the needs of your high-risk populations including addressing Transitions of Care. The recordings and live educational events listed below will help you focus your population health management, but don’t stop there. There are other high-risk populations that will need to be addressed in your practice workflows.

Collaborative Learning Recordings

○ Advance Care Planning and End-of-Life Care Discussions ○ Resource Allocations Strategies for Potentially Preventable ER Visits ○ Care Coordination Strategies to Support Effective Transitions of Care ○ How-to Succeed in Value-Based Payment Arrangements ○ Managing Chronic Conditions Using Care Optimization

Program Enhancements for 2019 | Collaborative Learning Recordings | Back to Calendar6

TechnologyMaximize your technological platform to ensure available features support your goals

Utilizing your EMR and health plan data sources will ensure you have the information you need to deliver quality care that closes care gaps and keeps your patients out of the hospital. Be sure to use all available technology to:

○ Implement quality reporting using your EMR/office templates ○ Utilize registry functionality to identify patient outreach that is needed and make those calls

Depending on the program you have contracted with, live trainings and recordings for your technology platform may be available throughout the year. If you are a PCMS user, you can contact your Contract Advisor for a list of recorded trainings or access the “PCMS Collaborative Learning Recordings” directly via the PCMS Quick Links option from within PCMS. The “PCMS Introduction and Demonstration” recording may be a good place to start.

Gaps in CareIdentify, close and prevent Gaps in Care to elevate quality

To improve health care outcomes and reduce costs to patients while meeting your scorecard goals, identify open care gaps and close them as appropriate. Remember to:

○ Identify closed care gaps that aren’t yet in the health plan data so you are utilizing clean reports ○ Implement a 30 day follow-up with patients to close care gaps as needed ○ Flag colorectal and breast cancer screenings that are outstanding ○ Flag diabetic eye exams that are outstanding

Collaborative Learning Recordings

○ Primary Care Practice Roundtable: Closing Gaps in Care and Completing Annual Visits ○ Primary Care Practice Roundtable: Utilizing Team-Based Care to Close Care Gaps

PartnershipsEngage your Enhanced Personal Health Care and Enhanced Personal Health Care Essentials support teams and utilize their knowledge and resources to move the needle

Depending on your program and contract, support services may be available. If you are contracted under a program that offers field team support, we recommend:

○ Discussing patient care plans for your commercial and Medicare Advantage patients ○ Setting quality and cost goals for your patients and your practice/organization ○ Identifying barriers to practice success and preparing a plan to remove them ○ Updating/developing practice procedures as needed ○ Sharing valuable information with providers and all practice staff ○ Utilizing health plan tools and resources as much as possible

Our national Collaborative Learning Program is designed each year to support your success. Refer to this guideline often to ensure you stay on target with your Patient-Centered Primary Care learning and patient care goals.

Program Enhancements for 2019 | Collaborative Learning Recordings | Back to Calendar7

Program Enhancements for 2019Beginning January 2019, there are enhancements to our program.

○ Presentation slides and additional resources for each Collaborative Learning event are available in your EPHC Provider Toolkit under the Collaborative Learning tab. Access to these materials will be made available after the event.

To access your EPHC Provider Toolkit directly, click here. Or follow the path below:

www.Anthem.com Providers Select your state Find Resources for “your state” Enhanced Personal Health Care Program Provider Toolkit Collaborative Learning tab

Tip: Bookmark or add the page to your favorites to quickly reference your EPHC Collaborative Learning resources.

○ We have enhanced our Recording Library so you can view recordings of our Collaborative Learning events.

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2019 Enhanced Personal Health Care

Collaborative Learning eCatalogEvent List, Dates and Descriptions

Did you register for an event and your practice firewall blocked the calendar invitation?

Don’t worry! All of our Collaborative Learning events use the same Adobe Connect meeting room URL.

Just block out the event time on your calendar and save this URL for easy access the day of the webinar.

https://antheminc.cosocloud.com/rgfcc49vhxyw/

Program Enhancements for 2019 | Collaborative Learning Recordings | Back to Calendar9

Depression and Anxiety Disorders: Impact, Screening and Treatment recording — offering 1.0 CME Credit Depression and anxiety are common conditions which have significant impact on patient well-being and quality of life, and can impact healthcare expenditures. Fortunately, these conditions respond well to treatment which is coordinated through integrated behavioral health and primary care interventions. Adequate screening, evaluation and referral to treatment are key components of success. Treatment interventions may include a combination of lifestyle and environmental interventions, psychotherapy, and medication targeting identified symptoms. From this perspective, treatment for depression and anxiety are must successful when approached from a condition care management perspective.

Learning objectives: ○ Recognize the prevalence of anxiety disorders and depression in different age groups ○ Review screening and evaluation processes in primary care settings ○ Understand current evidence based treatments ○ Understand how the condition care model can enhance management of these common behavioral health disorders in

primary care settings

Steven KornMD

Dr. Korn is the Medical Director for Behavioral Health for the Anthem Connecticut, Maine, New Hampshire and Empire Blue Cross and Blue Shield Plans. He provides clinical leadership for utilization management, case management and grievance and appeals of behavioral health services for members in New England and New York. He joined Anthem as a medical director in 2006.

Medicare Risk Adjustment Documentation and Coding Guidance: Red Flag HCCs, Part 1recording Part 1 of this Medicare risk adjustment documentation and coding webinar will provide in-depth information on a variety of conditions that are most commonly reported in error as identified by CMS and provide an overview of the CMS hierarchical condition categories for these conditions. Attendees will learn coding and documentation best practices for Chronic Kidney Disease (Stage 5), Ischemic or Unspecified Stroke, Cerebral Hemorrhage, Aspiration and Specified Bacterial Pneumonias, Unstable Angina and Other Acute Ischemic Heart Disease and End-Stage Liver Disease through the exploration of case studies and ICD-10-CM coding examples.

Learning objectives: ○ Understand the basics of Medicare Risk Adjustment ○ The impact of the conditions listed on Medicare Risk Adjustment ○ ICD-10-CM Coding and Documentation Guidance for the conditions listed

Michele ChathamCPC, CPMA, CRC

Michele Chatham is the lead medical records auditor and trainer with over 20 years of medical coding experience. Her background includes Medicare Outpatient billing, Medicare Secondary Payer subrogation and case investigations, and Federal Blue Cross benefits administration. For the last 12 years, she has performed retrospective claims auditing for Medicare Risk Adjustment, and her current position is with the Medicare Risk Adjustment Regulatory Compliance department where she provides training and educational materials as well as performing audits. She is a member of the AAPC and holds multiple certifications through them.

Program Enhancements for 2019 | Collaborative Learning Recordings | Back to Calendar10

Alcohol Use Disorder: Practical Tips for Identification and Management in Primary Carerecording — offering 1.0 CME Credit This presentation will focus on simple, practical and efficient tips for identifying and managing alcohol use disorder in primary care practice.

Learning objectives: ○ Audience members will learn at least one method of screening for Alcohol Use Disorder (AUD) ○ Audience members will learn at least one motivational interviewing technique that they can apply to managing AUD in

primary care ○ Audience members will learn when to manage AUD in primary care and when to refer ○ Audience members will learn how to manage AUD in primary care

Jorge A. CortinaMD

Jorge A. Cortina is the Medical Director for Behavior Health for UniCare, an Anthem Company, which is the largest Medicaid Managed Care Organization in West Virginia. As a healthcare executive over the last 21 years, Dr. Cortina has worked to improve the health of individuals with complex conditions by promoting novel and evidence-based models of care such as patient-centered medical homes, home based primary care, palliative care, and integrated behavioral and physical health care. In addition to his extensive career in health care management, he has also served as Clinical Associate Professor in the Department of Psychiatry at Eastern Virginia Medical School where he has received several teaching awards. He is board certified in Psychiatry and has subspecialty certifications in Addictions Psychiatry, Geriatric Psychiatry, and Palliative Medicine. He is a Distinguished Fellow of the American Psychiatric Association.

Using eConsult to Improve Access to Specialty Carerecording Patients typically only access specialty care services via face-to-face visits. Through eConsult, some consultations can be provided virtually in a more timely and member centric fashion. Even when a subsequent in person encounter with a specialist is required, eConsult improves efficiency by optimizing pre-visit testing, enhancing communication with the primary care provider and allowing prioritization of those visits based on clinical urgency. During this one hour webinar, the presenters will discuss the rationale for adopting eConsult, share practical tips for implementation and describe financing options under an advanced alternative payment methodology based on their two year experience with this digital health solution.

Learning objectives: ○ Understand the benefits and limitations of eConsult ○ Describe the challenges of an implementing an eConsult model from both the primary care and specialty physician

perspective ○ Identify the funding options to support an eConsult program

Art Jones MD

Dr. Jones has over 25 years of experience as a primary care physician and CEO at a Chicago area Community Health Center. He was one of the founders and continues to serve as the Chief Medical Officer for Medical Home Network (MHN) and is a principal at Health Management Associates. He is a graduate of the University of Illinois Medical School and completed internal medicine residency, chief residency and a cardiology fellowship at the University of Chicago.

Sana SyalMBA, FACP

Sana Syal has 8+ years of experience working in community health. Prior to joining Medical Home Network, Sana led diabetes management classes for adults and a youth nutrition program in several Chicago Public Schools in the Austin community. She currently manages the on-the-ground implementation of Medical Home Network’s various technology solutions, including eConsults. She received her Master’s in Public Health, with a focus on Health Management and Policy, from the University of Michigan.

Program Enhancements for 2019 | Collaborative Learning Recordings | Back to Calendar11

Medicare Risk Adjustment Documentation and Coding Guidance: Red Flag HCCs, Part 2recording Part 2 of this Medicare risk adjustment documentation and coding webinar will provide in-depth information on a variety of conditions that are most commonly reported in error as identified by CMS and provide an overview of the CMS hierarchical condition categories for these conditions. Attendees will learn coding and documentation best practices for Atherosclerosis of the Extremities with Ulceration or Gangrene, Myasthenia Gravis/Myoneural Disorders and Guillain-Barre Syndrome, Drug/Alcohol Psychosis, Lung and Other Severe Cancers, and Diabetes with Ophthalmologic or Unspecified Manifestations through the exploration of case studies and ICD-10-CM coding examples.

Learning objectives: ○ Understand the basics of Medicare Risk Adjustment ○ The impact of the conditions listed on Medicare Risk Adjustment ○ ICD-10-CM Coding and Documentation Guidance for the conditions listed

Michele ChathamCPC, CPMA, CRC

Michele Chathem is the lead medical records auditor and trainer with over 20 years of medical coding experience. Her background includes Medicare Outpatient billing, Medicare Secondary Payer subrogation and case investigations, and Federal Blue Cross benefits administration. For the last 12 years, she has performed retrospective claims auditing for Medicare Risk Adjustment, and her current position is with the Medicare Risk Adjustment Regulatory Compliance department where she provides training and educational materials as well as performing audits. She is a member of the AAPC and holds multiple certifications through them.

Opioid Use Disorder 101recording As a nation, we are in the throes of an opioid overdose epidemic of unprecedented proportions. Death rates related to overdose from illicit forms of opioids have been particularly pronounced since the introduction of illicit forms of fentanyl into the drug supply starting in 2016. What are treatment options for opioid use disorder? Who is responsible for screening and evaluation? When is it appropriate to make a referral to treatment for opioid use disorder? How prevalent is opioid use disorder? These are all questions which will be addressed during this session.

Learning objectives: ○ Understand the current epidemics of opioid use disorder and opioid overdose ○ Recognize screening and evaluation processes in primary care settings ○ Review current evidence based treatments ○ Understand how the condition care model can enhance management of opioid use disorders in primary care settings

Steven KornMD

Dr. Korn is the Medical Director for Behavioral Health for the Anthem Connecticut, Maine, New Hampshire and Empire Blue Cross and Blue Shield Plans. He provides clinical leadership for utilization management, case management and grievance and appeals of behavioral health services for members in New England and New York. He joined Anthem as a medical director in 2006.

Program Enhancements for 2019 | Collaborative Learning Recordings | Back to Calendar12

Bringing Value with Patient Self-Management Supportrecording As the health care environment navigates value-based care, the engagement of patients in their health becomes even more important. Dr. Kathy Reims will describe evidence-based components of a strong patient self-management program and share strategies that have been successful to identify, engage and support patients to better manage their health.

Learning objectives: ○ List essential attributes of a patient self-management support program in primary care ○ Understand strategies to identify patients who will benefit from self-management support ○ Explore what works (and what doesn’t!) to engage patients in self-management support

Kathy ReimsMD, FAAFP

Dr. Reims is the Chief Medical Officer for CSI Solutions and has served as an improvement advisor and faculty member for numerous health systems improvement projects across the US and Canada. She is a Master Trainer for the Centre for Collaboration, Motivation and Innovation (CCMI), and is a member of the Motivational Interviewing Network of Trainers (MINT) as well as adjunct faculty with the Institute for Healthcare Improvement.

How an EPHC Organization Manages Chronic Conditions Using Care Optimization and Continuous Quality Improvement to Improve Outcomesrecording During this presentation Dr. Hines will discuss the ways in which his organization, Crystal Run Healthcare, uses the concepts of Care Optimization, Continuous Quality Improvement, and Variation Reduction to promote better outcomes for chronic diseases. This approach engages both primary care providers, specialists, and other members of the healthcare team and has been applied to multiple chronic conditions including diabetes, hypertension, and COPD.

Learning objectives: ○ Understand the principles of Care Optimization and how this process prevents gaps in care and closes such gaps when

they do occur ○ Understand how the process of Continuous Quality Improvement can engage the entire healthcare team and lead to

better outcomes ○ Understand the process of Variation Reduction and how increased awareness of and adherence to evidence based

practice guidelines can improve outcomes

Scott HinesMD

Dr. Hines is Crystal Run Healthcare’s Chief Quality Officer, Medical Director and physician leader for Crystal Run Healthcare’s medical specialties division. Dr. Hines is board certified in Internal Medicine, Endocrinology, Diabetes and Metabolism.

Program Enhancements for 2019 | Collaborative Learning Recordings | Back to Calendar13

Medicare Risk Adjustment Documentation and Coding Guidance: Opioids and more – Substance Abuse and Dependencerecording This Medicare risk adjustment documentation and coding webinar will provide in-depth information on substance abuse and dependence and provide an overview of the CMS hierarchical condition categories for these conditions. Attendees will learn coding and documentation best practices for substance abuse and dependence through the exploration of case studies and ICD-10-CM coding examples.

Learning objectives: ○ Understand the basics of Medicare Risk Adjustment ○ The impact of substance abuse and dependence on Medicare Risk Adjustment ○ ICD-10-CM Coding and Documentation Guidance for substance abuse and dependence

Michele ChathamCPC, CPMA, CRC

Michele Chatham is the lead medical records auditor and trainer with over 20 years of medical coding experience. Her background includes Medicare Outpatient billing, Medicare Secondary Payer subrogation and case investigations, and Federal Blue Cross benefits administration. For the last 12 years, she has performed retrospective claims auditing for Medicare Risk Adjustment, and her current position is with the Medicare Risk Adjustment Regulatory Compliance department where she provides training and educational materials as well as performing audits. She is a member of the AAPC and holds multiple certifications through them.

Supporting Care Planning and Coordination in Primary Carerecording As health care shifts from fee-for-service to value-based reimbursement, healthcare organizations need to develop Population Health initiatives that enhance quality, outcomes and cost efficiency. Development of Care Coordination is one initiative that can yield the desired quality, outcomes and cost efficiency using protocols for managing high risk patients. Organizations need to understand the foundational components of a Care Coordination program including the identification of the patient population, developing a nursing framework, setting caseload expectations, developing documentation and EMR needs, engaging caregivers, ensuring program consistency, measuring success and establishing data/reporting needs. Creating customized care plans, using registries and closing care gaps will also be discussed.

Learning objectives: ○ Understand the foundation and structures that are integral in building a successful Care Coordination program ○ Explore the key structures noted above with the speaker, and recognize the value each brings to a Care Coordination

program ○ Provide examples of how a health care organization can provide for the key components of a successful Care

Coordination program

Kristine KelmRN, Executive Director of Ambulatory Care Management, Advocate Aurora Health Care

Kristine Kelm currently holds the position of Director of Care Coordination & Population Health at Aurora Health Care. She is responsible for providing leadership for the primary care based RN Care Coordinator and the Community Based Case Management programs. She has over 20 years of experience overseeing Quality, Case Management, Social Services, and Palliative Care programs.

Program Enhancements for 2019 | Collaborative Learning Recordings | Back to Calendar14

Strategies to Improve Adherence and Medication Reconciliationrecording Understanding challenges and barriers is fundamental to improving medication adherence and providing effective medication reconciliation. With endorsement from organizations such as, HEDIS and NCQA, Medication Adherence and Medication Reconciliation have taken spotlight to improve patient outcomes and patient safety. This session will focus on strategies for performing medication reconciliation, effective methods for improving medication adherence, and sharing information on how to implement best practice approaches.

Learning objectives: ○ Define medication adherence and medication reconciliation ○ Describe the impact of medication adherence and medication reconciliation ○ Identify common barriers to patient adherence ○ Review real-world tactics for improving medication reconciliation and adherence in daily practice

Courtney LeePharmD, Anthem Clinical Pharmacist

Courtney Lee is a clinical pharmacist for Anthem’s Pharmacy Benefits Manager, IngenioRx.  Her background includes providing pharmacy supporting for the interdisciplinary team for a small health plan and as a manager overseeing development and implementation of retrospective drug utilization review programs that support pharmacy related quality metrics for a pharmacy benefits manager. Her current role with IngenioRx provides pharmacy support for the Enhanced Personal Health Care program.

Medicare Risk Adjustment Documentation and Coding Guidance: Acute, Chronic and Status Conditionsrecording This Medicare risk adjustment documentation and coding webinar will provide in-depth information on acute, chronic and status conditions and provide an overview of the CMS hierarchical condition categories for these conditions. Attendees will learn coding and documentation best practices for acute, chronic and status conditions through the exploration of case studies and ICD-10-CM coding examples.

Learning objectives: ○ Understand the basics of Medicare Risk Adjustment ○ The impact of the acute, chronic and status conditions on Medicare Risk Adjustment ○ ICD-10-CM Coding and Documentation Guidance for acute, chronic and status conditions

Michele ChathamCPC, CPMA, CRC

Michele Chathem is the lead medical records auditor and trainer with over 20 years of medical coding experience. Her background includes Medicare Outpatient billing, Medicare Secondary Payer subrogation and case investigations, and Federal Blue Cross benefits administration. For the last 12 years, she has performed retrospective claims auditing for Medicare Risk Adjustment, and her current position is with the Medicare Risk Adjustment Regulatory Compliance department where she provides training and educational materials as well as performing audits. She is a member of the AAPC and holds multiple certifications through them.

Program Enhancements for 2019 | Collaborative Learning Recordings | Back to Calendar15

Influencing Better Health: An Overview of the Current and Future State of Social Determinants of Healthrecording The places where we live, learn, work and play – also referred to as the social determinants of health (SDoH) – can have a major impact on an individual’s overall health and well-being. As an evolving area of attention in the health care industry and an important initiative at Anthem, this interactive webinar will focus on SDoH as a key driver of health; examine how addressing a patient’s unmet needs can help bridge gaps in care; review the current state of provider assessments and strategies; and explore next steps for improving patient-centered care.

Learning objectives: ○ Review the Social Determinants of Health (SDoH) and their influence on an individual’s health and well-being. ○ Examine how SDoH impacts all segments and communities and discuss how addressing a patient’s unmet needs can

contribute to better overall health and improved satisfaction. ○ Explore how some providers are addressing SDoH through assessments and interventions to bridge gaps in care and

deliver a more patient-centered approach.

Kathryn RowerdinkMPH, MBA, Director Clinical Strategy

Kathryn Rowerdink works in Anthem’s Clinical Strategy & Programs organization, focused on enterprise wide strategies and solutions. She earned her master’s degree in public health from California State University, Northridge and her master’s degree in business administration from Pepperdine University. She is continuing her education by obtaining her certification in design thinking and completing Anthem’s leadership development program.

Implementing Motivational Interviewing to Promote Behavior Change: A Practice’s Perspectiverecording Understanding a patient’s level of engagement and identifying their current ‘Stage of Change’ can prove challenging at times so our 2018 presenters are returning to review Motivational Interviewing techniques and their recommendations for a collaborative approach to patient interaction along with an Enhanced Personal Health Care practice who is implementing their recommendations. Participants will learn about the progress, successes and challenges experienced by at least one practice during an exciting peer-to-peer sharing event.

Learning objectives: ○ Understand the stages of change and motivational interviewing principles ○ Learn how their peer(s) have modified their patient encounters to promote behavior change ○ Feel even more empowered to adopt MI techniques in their practice

Neha Patel, LPCNeha Patel has a Masters in Counseling Psychology from the University of Denver and a Masters in Management from Colorado State University. She is the Director of Care Delivery Transformation for the Southeast Region for the Enhanced Personal Health Care Program.

Tiffany Ransel, LPC, CAC III Tiffany Ransel is a licensed professional counselor and certified addictions counselor in the state of Colorado. In 2014, she joined the Enhanced Personal Health Care Team and began working with primary care practices on practice improvement efforts. She now leads the Care Delivery Transformation teams in Colorado, California, Missouri, and Wisconsin.

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Medicare Risk Adjustment Documentation and Coding Guidance: Diabetes Mellitus and other Metabolic Disordersrecording This Medicare risk adjustment documentation and coding webinar will provide in-depth information on Diabetes Mellitus and other metabolic disorders and provide an overview of the CMS hierarchical condition categories for these conditions. Attendees will learn coding and documentation best practices for Diabetes Mellitus and other metabolic disorders through the exploration of case studies and ICD-10-CM coding examples.

Learning objectives: ○ Understand the basics of Medicare Risk Adjustment ○ The impact of Diabetes Mellitus and other metabolic disorders on Medicare Risk Adjustment ○ ICD-10-CM Coding and Documentation Guidance for Diabetes Mellitus and other metabolic disorders

Michele ChathamCPC, CPMA, CRC

Michele Chatham is the lead medical records auditor and trainer with over 20 years of medical coding experience. Her background includes Medicare Outpatient billing, Medicare Secondary Payer subrogation and case investigations, and Federal Blue Cross benefits administration. For the last 12 years, she has performed retrospective claims auditing for Medicare Risk Adjustment, and her current position is with the Medicare Risk Adjustment Regulatory Compliance department where she provides training and educational materials as well as performing audits. She is a member of the AAPC and holds multiple certifications through them.

Improving Access to Care in the Medical NeighborhoodOctober 10, 2019 Access to convenient, timely and appropriate ambulatory health care has shown to impact a patients’ ability to prevent illness, control acute episodes and manage chronic conditions to avoid exacerbation of those conditions. Some important strategies for better access is to remove barriers to care and make it easy for patients to schedule an appointment and see a doctor the day they call. Proactively managing the supply and demand for appointments and use technology for convenience when appropriate are also important. In this learning event we will educate the care team on how to reduce delays in care through enhanced access strategies, improve non-visit patient communication, and offer solutions for backlogs and extended wait times.

CANCELED

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Utilizing Care Compacts to Enhance the Value of Specialty ReferralsNovember 14, 2019 Specialty referrals play a critical role in patient care. However, without adequate infrastructure, the referral processes between primary care and specialty care can contribute to unnecessary costs and worse rather than better outcomes. This poor communication can lead to frustration and dissatisfaction for clinicians, but it is the patients who pay the biggest price, with poor outcomes and personal costs in time, money and safety. The Medical Neighbor approach provides critical infrastructure elements to improve the referral process. One of these elements, the care coordination agreement or compact, defines the mutual expectations around communication and information exchange and serves as an invitation to work together to provide coordinated, continuous care. This webinar will provide practical guidance on what the critical elements and processes are for care compacts and a more effective, efficient and patient-centered referral process.

Learning objectives: ○ Articulate the purpose of a care coordination compact & the basic as well as optional components that enhance

communication and care coordination with referrals within the Medical Neighborhood ○ Describe and establish internal practice and collaborative processes that support the care compact and enable a high

value referral process ○ Recognize practical steps to creating a more patient-centered referral process

Dr. Carol GreenleeFACP, FACE

Dr. Greenlee is board certified in Internal Medicine and in Endocrinology, Diabetes and Metabolism with over 30 years’ experience in private practice endocrinology. She currently serves as one of the faculty co-chairs for the Transforming Clinical Practice initiative (TCPi). In 2014, her solo endocrinology practice achieved tier 3 NCQA Patient-Centered Specialty Practice (PCSP) recognition as an early adopter.

Medicare Risk Adjustment Documentation and Coding Guidance: Behavioral HealthNovember 27, 2019 — offering 1.0 CME Credit This Medicare risk adjustment documentation and coding webinar will provide in-depth information on behavioral health conditions and provide an overview of the CMS hierarchical condition categories for these conditions. Attendees will learn coding and documentation best practices for behavioral health conditions through the exploration of case studies and ICD-10-CM coding examples.

Learning objectives: ○ Understand the basics of Medicare Risk Adjustment ○ The impact of the behavioral health conditions on Medicare Risk Adjustment ○ ICD-10-CM Coding and Documentation Guidance for behavioral health conditions

Michele ChathamCPC, CPMA, CRC

Michele Chatham is the lead medical records auditor and trainer with over 20 years of medical coding experience. Her background includes Medicare Outpatient billing, Medicare Secondary Payer subrogation and case investigations, and Federal Blue Cross benefits administration. For the last 12 years, she has performed retrospective claims auditing for Medicare Risk Adjustment, and her current position is with the Medicare Risk Adjustment Regulatory Compliance department where she provides training and educational materials as well as performing audits. She is a member of the AAPC and holds multiple certifications through them.

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Medicare Risk Adjustment and Documentation Guidance SeriesMonthly Provider Onboarding

offers 1.0 CME credit for attending one LIVE event

August 7, 2019 — September 4, 2019 — October 2, 2019 — November 6, 2019 — December 4, 2019

The Medicare Revenue and Reconciliation Compliance team has developed a provider onboarding training titled Medicare Risk Adjustment and Documentation Guidance. The purpose of this training is to help ensure providers understand the basics of Medicare Risk Adjustment and the importance of proper medical record documentation and coding.

During this training, we will discuss: ○ Risk Adjustment Overview ○ Calculation of Risk Adjustment Factor ○ Characteristics of the CMS-HCC Model ○ HCCs and their Impact ○ The Provider’s Role ○ Medical Record Documentation and Coding Best Practices

Unable to attend a LIVE event? A recording is available for viewing 24/7.

Disclaimer: This training is based on coding guidance from the Official ICD-10-CM Coding Guidelines, American Hospital Association’s (AHA) Coding Clinic, and/or Centers for Medicare and Medicaid Services (CMS) guidance and guidelines. As the ICD-10-CM code set is updated annually, coding requirements and standards are subject to change, potentially impacting the accuracy of the content contained within this presentation.

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Collaborative Learning Recording LibraryOur extensive online recording library, containing recordings of our Collaborative Learning Events, is available to you 24 hours a day, 7 days a week, 365 days a year to accommodate your busy schedule. Here you can review and reference recordings of collaborative learning webinars designed to help you meet your participation requirements under Enhanced Personal Health Care.

Collaborative Learning Recordings

Implementing Motivational Interviewing to Promote Behavior change: A Practice’s Perspective

Presented by Anthem’s Tiffany Ransel and Neha Patel, this webinar reviewed Motivational Interviewing techniques for a collaborative approach to patient interaction. Two EPHC practices shared their progress, success and experiences implementing MI in their offices.

Medicare Risk Adjustment Documentation and Coding Guidance: Diabetes Mellitus and other Metabolic Disorders

Presented by Anthem’s Michele Chatham, this webinar provided in-depth information on Diabetes Mellitus and other metabolic disorders and an overview of the CMS hierarchical condition categories for these conditions.

Influencing Better Health: An Overview of the Current and Future State of Social Determinants of Health

Presented by Anthem’s Kathryn Rowerdink, this webinar focused on Social Determinants of Health (SDoH) as a key driver of health while examining how addressing a patient’s unmet needs can help bridge gaps in care. Kathryn also reviewed the current state of provider assessments and strategies, and explored next steps for improving patient-centered care. An EPHC practice presented on their paramedicine program to address Social Determinants of Health for their patients.

Strategies to Improve Adherence and Medication Reconciliation

Together, IngenioRx's Courtney Lee, PharmD, and TriHealth's Carolyn Vance, Population Health Pharmacy Manager, presented the impact quality medication adherence and reconciliation can have on patient outcomes. In addition, they explored common barriers to patient adherence and gave real world examples and tactics for improving medication reconciliation and adherence in daily practice.

Medicare Risk Adjustment Documentation and Coding Guidance: Acute, Chronic and Status Conditions

Anthem’s Michele Chatham provided in-depth information on acute, chronic and status conditions and provided an overview of the CME hierarchical condition categories for these conditions.

Supporting Care Planning and Coordination in Primary Care

Kristine Kelm, RN, Executive Director of Ambulatory Care Management at Advocate Aurora Health (an EPHC organization) presented on the Care Coordination programs focusing on quality, outcomes and cost efficiency currently implemented at Advocate Aurora Health.

How an EPHC Organization Manages Chronic Conditions Using Care Optimization and Continuous Quality Improvement to Improve Outcomes

Dr. Hines, Chief Quality Officer for Crystal Run Healthcare, discussed the ways in which his organization uses the concepts of Care Optimization, Continuous Quality Improvement, and Variation Reduction to promote better outcomes for chronic diseases.

Medicare Risk Adjustment Documentation and Coding Guidance: Opioids and more - Substance Abuse and Dependence

Anthem’s Michele Chatham provided in-depth information on substance abuse and dependence and provided an overview of the CME hierarchical condition categories for these conditions.

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Bringing Value with Patient Self-Management Support

Dr. Reims shared how the engagement of patients in their health becomes even more important as the health care envioronment navigates value-based care. She also shared evidence-based components of a strong patient self-management program.

Opioid Use Disorder 101 Dr. Korn presented on the current epidemics of opioid use disorder and opioid overdose. He also reviewed the screening and evaluation processes for primary care settings in addition to evidence based treatments.

Medicare Risk Adjustment Documentation and Coding Guidance: Red Flag HCCs, Part 2

Part 2 of this Medicare Risk Adjustment documentation and coding webinar provides in-depth information on a variety of conditions that are most commonly reported in error.

Alcohol Use Disorder: Practical Tips for Identification and Management in Primary Care

This presentation focused on simple, practical and efficient tips for identifying and managing alcohol use disorder in primary care practice.

Using eConsult to Improve Access to Specialty Care

The presenters discussed the rationale for adopting eConsult, shared practical tips for implementation and described financing options under an advanced alternative payment methodology.

Depression & Anxiety Disorders: Children bonus session

Because depression and anxiety have significant impact on children, this bonus recording will review evidence-based treatments and how to enhance management of these disorders in the primary care setting.

Medicare Risk Adjustment Documentation and Coding Guidance: Red Flag HCCs, Part 1

Part 1 of this Medicare Risk Adjustment documentation and coding webinar will provide in-depth information on conditions that are most commonly reported in error as identified by CMS and provide an overview of CMS hierarchical condition categories.

Depression and Anxiety Disorders: Impact, Screening and Treatment

Because depression and anxiety have significant impact on patient well-being, health care expenditures and quality of life, we will review evidence-based treatments and how to enhance management of these disorders in the primary care setting.

Medicare Risk Adjustment Documentation and Coding Guidance: Dependency

A bi-monthly training series designed to focus on specific conditions that affect Medicare Risk Scores.

The Integrative Approach to Pain Management: A non-opioid treatment model for addressing chronic pain

Effective pain management requires an integrative approach. We will present a disciplined model for effective and responsible pain management using interventional techniques, pharmacological management, physical modalities, eastern medicine, and more.

Factors Associated with Improved Quality, Utilization, and Cost---Findings from the EPHC Provider Organization Survey

A review of the findings of a survey study of large EPHC provider organizations. The study sought to describe organization-level attributes and investments in care transformation, and their relationship with cost, quality, and utilization performance.

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Integrating Clinical Pharmacists to Provide Comprehensive Medication Management

Join us for an informative session as Amanda Brummel, PharmD, BCACP shares how Fairview Health System has successfully integrated clinical pharmacists in their ambulatory clinics to provide Comprehensive Medication Management (CMM) services.

Medicare Risk Adjustment Documentation and Coding Guidance: Diabetes

A bi-monthly training series designed to focus on specific conditions that affect Medicare Risk Scores.

Implementing Practice Based Care Management – How InterMed (an EPHC multi-specialty physician owned organization in Maine) Rocks Their Utilization Targets

Join the CEO of InterMed, a multi-specialty physician owned organization, as he shares the Practice Based Care Management model and how it can be used to reduce admissions, ER utilization and hospital readmission rates to hit program targets.

Primary Care Practice Roundtable: Utilizing Team-Based Care to Close Gaps in Care

Please join us for the discussion as a roundtable of your peers shares their experiences utilizing team-based care to close care gaps.

Medicare Risk Adjustment Documentation and Coding Guidance: Respiratory Disease

A bi-monthly training series designed to focus on specific conditions that affect Medicare Risk Scores.

How-to Succeed in Value-Based Payment Arrangements

Navigating the contemporary healthcare landscape can be challenging! This exciting and inspiring presentation will demonstrate how you can be successful under value based payment arrangements and how one practice has learned to walk the talk.

Reducing Hospital Readmissions - Let us show you how and why

Readmission reduction is the hottest trending topic in healthcare today because the potential to impact cost and quality is so significant! This session includes protocols, tools, and suggestions for creating your own Transitional Care program.

Care Planning and Coordination: Managing Complex Pediatric Patients

Join us to explore the medically complex population and review strategies to optimize medical and health outcomes. The extensive needs for health services and high resource utilization will be discussed in addition to achieving high-value health care.

Resource Allocation Strategies for Preventable ER Visits

Dr. Michael Smith from Anthem shares principles and practices to effectively and efficiently address identifying burden of illness, closing gaps in care, and resource allocation with particular emphasis on reducing potentially preventable ER visits.

Primary Care Practice Roundtable of Your Peers - Closing Gaps in Care and Completing Annual Visits

Join us for the discussion as a roundtable of your peers shares their experiences closing gaps in care and completing annual visits.

Medicare Risk Adjustment Documentation & Coding: Cardiovascular Conditions

A bi-monthly training series designed to focus on specific conditions that affect Medicare Risk Scores.

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Adult ADHD: Current Trends and Best Practice Treatment

Attention Deficit Disorder, or ADHD, is a widely recognized and researched behavior-al health disorder. This webinar will not only focus on the defining characteristics of ADHD, but will also focus on how this disorder can be manifested in adulthood.

Care Coordination Strategies to Support Effective Transitions of Care

This webinar will present an opportunity to review the current state of transitional care in America and offer information regarding care coordination strategies to support the delivery of safe and effective transitions of care.

EPHC Strategies for Reducing Cost of Care

This session will describe Enhanced Personal Health Care strategies that practices can use to help their patients select high value sites of service for such healthcare services as laboratory, ambulatory surgery and radiology procedures.

Medicare Risk Adjustment Documentation and Coding Guidance: Vascular Disease

A bi-monthly training series designed to focus on specific conditions that affect Medicare Risk Scores.

Advance Care Planning and End-of-Life Care Discussions

This presentation will discuss strategies that clinicians can incorporate into their everyday practice to have supportive advance care planning and end-of-life care discussions, with a review of commonly used advance directive documents.

Improving the Patient Experience using the QUEST Model

During this session Dr. Tom Scaletta will explore how the patient experience directly influences clinical outcomes, safety and cost measures as satisfied and engaged patients have better clinical compliance.

Motivational Interviewing in Primary Care This session will review Stages of Change and the Motivational Interviewing techniques utilized to move a patient towards action.

Medicare Risk Adjustment Documentation and Coding Guidance: Acute, Chronic & Status Conditions

A bi-monthly training series designed to focus on specific conditions that affect Medicare Risk Scores.

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The SHARE Approach to Shared Decision-MakingEngage your patients in their health care

The SHARE Approach occurs when a health care provider and a patient work together to make a health care decision that is best for the patient. The optimal decision takes into account evidence-based information about available options, the provider’s knowledge and experience, and the patient’s values and preferences. Emerging evidence suggests that shared decision-making benefits the patient (improves satisfaction with care) and the provider organization (improves quality and may reduce costs).

This recorded series is adapted from the AHRQ SHARE Approach curriculum. The SHARE Approach was created by the Agency for Healthcare Research and Quality, Rockville, MD. This series is developed with permission from Agency for Healthcare Research and Quality (AHRQ): The SHARE Approach.

○ Module 1: Overview (1 CME) ○ Module 2: Communication (1 CME) ○ Module 3: Putting Into Place (1 CME)

○ Activity 1: Conversation Role Play (1 CME) ○ Activity 2: Using Decision Aids Role Play (1 CME)

AAFP Prescribed CME credit will be available for participating in the recorded series.

This Live series activity, Primary Care Practice Transformation Collaborative Learning series, from 01/01/2019 - 12/31/2019, has been reviewed and is acceptable for credit by the American Academy of Family Physicians. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Approved for 1.0 AAFP Prescribed credits.

Did you register for an event and your practice firewall blocked the calendar invitation?

Don’t worry! All of our Collaborative Learning events use the same Adobe Connect meeting room URL.

Just block out the event time on your calendar and save this URL for easy access the day of the webinar.

https://antheminc.cosocloud.com/rgfcc49vhxyw/

For self-funded plans, claims are administered by UniCare Life & Health Insurance Company.