Care Coordination Panel Discussion JANSSEN CONNECT

Size: px
Start display at page:

Download "Care Coordination Panel Discussion JANSSEN CONNECT"

Transcription

1 Care Coordination Panel Discussion JANSSEN CONNECT Jeremy Mann May 5, 2014 #NatCon14 Disclaimer The content of this presentation is the personal views of the presenter, Jeremy Mann, and does not necessarily represent the views of Janssen Pharmaceuticals, Inc. #NatCon14 1 1

2 Disclaimer Analytics about the program as of the date noted may not be representative of future analytics or your patients or practice. Please consider appropriate use of JANSSEN CONNECT information and assistance in light of your practice and individual patients clinical needs and applicable payer requirements. Information and assistance (e.g., information regarding access and reimbursement, the inpatient/outpatient appointment gap, medication shipment, additional Injection Center options, and follow-through of HCP-directed treatment plan) are provided by United BioSource Corporation ( UBC ), under contract for Janssen Pharmaceuticals, Inc. ( JPI ). A Patient Enrollment Form ( PEF ), with sections completed for requested information regarding assistance, must be submitted to UBC by the healthcare professional ( HCP ) in order to activate any JANSSEN CONNECT assistance. No other forms for request for access to JANSSEN CONNECT will be accepted. Assistance cannot be directly requested by the patient. JANSSEN CONNECT is not available to patients participating in a Patient Assistance Program ( PAP ). The availability of information and assistance may vary based on geography. UBC provides information to healthcare professionals ( HCPs ) regarding whether the treatment is covered by the applicable third-party payer, based on the payer s coverage guidelines and the patient information provided by the HCP. This information and assistance are made available as a convenience to patients, and there is no requirement that patients or HCPs use any JPI or other Johnson & Johnson product in exchange for this information or assistance. JPI assumes no responsibility for and does not guarantee the quality, scope, or availability of the information and assistance provided (e.g., information regarding access and reimbursement, the inpatient/outpatient appointment gap, medication shipment, additional Injection Center options, and follow-through of HCP-directed treatment plan). UBC, not JPI, is responsible for the information and assistance it provides under this program. Each HCP and patient is responsible for verifying or confirming any information provided by UBC or JPI. All claims and other submissions to payers should be in compliance with all applicable requirements. #NatCon14 2 Care Coordination Is the deliberate organization of patient care activities between two or more participants involved in a patient s care to facilitate the appropriate delivery of healthcare services. 1 Reference: 1. McDonald KM, Sundaram V, Bravata DM, et al. Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies, Volume 7 Care Coordination. Rockville, MD: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services; June #NatCon14 3 2

3 Janssen Connect does not directly provide care coordination. The Janssen Connect program supports patients by supporting healthcare professional initiatives in care coordination. Janssen Connect offers comprehensive information and assistance to help patients stay on their Janssen long-acting injectable atypical antipsychotic after a healthcare professional has determined it to be the most clinically appropriate treatment option to prescribe. #NatCon14 4 The Need for JANSSEN CONNECT : Gaps in Mental Health Treatment in America Reduced number of state psychiatric beds due to decades of cuts in state and federal mental healthcare funding 1 According to a retrospective longitudinal cohort analysis, 41% of patients received no psychiatric follow-up 1 month after hospital discharge 2 If we are going to help support care coordination, more needs to be done to help patients in taking their healthcare professional-ordered medication. References: 1. The National Alliance on Mental Illness. State Mental Health Cuts: A National Crisis. Chicago; Olfson M, Marcus SC, Doshi JA. Continuity of care after inpatient discharge of patients with schizophrenia in the Medicaid program: a retrospective longitudinal cohort analysis. J Clin Psychiatry. 2010;71: #NatCon14 5 3

4 Patient Barriers* & Treatment Challenges Patients may face healthcare system-related challenges after a long-acting injectable antipsychotic is prescribed: Access and reimbursement understanding The inpatient/outpatient appointment gap Ensuring product is on hand Additional injection center options Follow-through of healthcare professional-directed treatment plan *Derived from market research. #NatCon14 6 Information and Assistance to Help Patients AIDING access and reimbursement understanding Research about your patients Janssen long-acting therapy coverage status #NatCon14 7 4

5 Information and Assistance to Help Patients BRIDGING the inpatient/outpatient appointment gap Information and assistance to help transition between care settings #NatCon14 8 Information and Assistance to Help Patients COORDINATING medication shipment Assistance coordinating shipment of patient medication to physician offices #NatCon14 9 5

6 Information and Assistance to Help Patients DETERMINING additional injection center options Patients can receive healthcare professional-ordered injections at a location that may be more conveniently located for them #NatCon14 10 Information and Assistance to Help Patients ENCOURAGING follow-through of a healthcare professional-directed treatment plan Ongoing communication to patients and healthcare professionals regarding treatment follow-through #NatCon

7 #NatCon14 12 Key Facts 16,000+ patients received information and assistance since ~150 patients per week requesting information and assistance 1 Over 2,700+ healthcare professionals 1 and 30,000+ injections administered 1 85% of JANSSEN CONNECT patients returned to an injection center after their first injection 1,2 92% of answered JANSSEN CONNECT reminder calls resulted in an injection 1,3 More than 60% of patients received a successful injection post-discharge as ordered by their healthcare professional 4 This percentage represents hospitalized patients who scheduled a JANSSEN CONNECT Injection Center appointment who went on to receive a successful injection as ordered by their healthcare professional once they left the hospital. Successful injection indicates that the patient attended an appointment to receive his or her healthcare professional-ordered injection and does not refer to clinical outcome. References: 1. Data derived from monthly analytics from JANSSEN CONNECT program. As of 3/31/ Number of patients who received more than one injection/number of patients who received injections. (2355/2764)*100%=85.20%. 3. Number of answered reminder calls resulting in an injection/number of answered reminder calls (12588/13593)*100%=92.61%. 4. Number of patients with inpatient facility on PEF who scheduled and completed an injection center appointment/number of patients with inpatient facility on PEF who scheduled an injection center appointment (367/530 = 69.25%). As of 04/14. #NatCon

8 2014 Expansion In 2014, JANSSEN CONNECT has expanded nationally: 21 states with full JANSSEN CONNECT model All states with some level of JANSSEN CONNECT information and assistance #NatCon14 14 In Summary The JANSSEN CONNECT program supports patients by supporting healthcare professional initiatives in care coordination: Addresses gaps in mental health treatment in America Focuses on healthcare system-related challenges after a Janssen long-acting injectable antipsychotic is prescribed Offers comprehensive information and assistance to help patients stay on their Janssen long-acting injectable atypical antipsychotic after a healthcare professional has determined it to be the most clinically appropriate treatment option Since 2011, JANSSEN CONNECT has provided information and assistance to 16,000+ patients 1 at the direction of 2,700+ healthcare professionals 1 Administered 30,000+ injections 1 with 85% of patients 2 returning after their first injection In 2014, JANSSEN CONNECT has expanded nationally to bring some level of information and assistance to all states Many unmet needs remain in care coordination for patients. Janssen Connect is one program that can support patients by supporting healthcare professional initiatives in care coordination. References: 1. Data derived from monthly analytics from JANSSEN CONNECT program. As of 3/31/ Number of patients who received more than one injection/number of patients who received injections. (2355/2764)*100%=85.20%. #NatCon

Reducing Care Fragmentation Executive Summary

Reducing Care Fragmentation Executive Summary Reducing Care Fragmentation Executive Summary A TOOLKIT FOR COORDINATING CARE Reducing Care Fragmentation 49 Executive Summary Reducing Care Fragmentation: A Toolkit for Coordinating Care is for clinics,

More information

Care Transitions in Behavioral Health

Care Transitions in Behavioral Health Janssen Pharmaceuticals, Inc. Presents: Care Transitions in Behavioral Health Chuck Ingoglia, MSW Senior Vice President, Policy and Practice Improvement, National Council for Behavioral Health Nina Marshall,

More information

The Psychiatric Shortage:

The Psychiatric Shortage: ational Council Medical Director Institute The Psychiatric Shortage: National Council Medical Causes and Solutions Director Institute Update National Council Medical Director Institute Medical directors

More information

Care Transitions Engaging Psychiatric Inpatients in Outpatient Care

Care Transitions Engaging Psychiatric Inpatients in Outpatient Care Care Transitions Engaging Psychiatric Inpatients in Outpatient Care Mark Olfson, MD, MPH Columbia University New York State Psychiatric Institute New York, NY A physician is obligated to consider more

More information

Caring for the Underserved - Innovative Pharmacy Practice Integration

Caring for the Underserved - Innovative Pharmacy Practice Integration Caring for the Underserved - Innovative Pharmacy Practice Integration Sarah T. Melton, PharmD, BCPP, BCACP, FASCP Associate Professor Pharmacy Practice Clinical Pharmacist, Johnson City Community Health

More information

Legal Issues You Should Know April 25, 2018 In-House Counsel Conference

Legal Issues You Should Know April 25, 2018 In-House Counsel Conference 1 TELEMEDICINE Legal Issues You Should Know April 25, 2018 In-House Counsel Conference Disclaimer: These materials and presentation are intended to be a general and brief summary of the law. This is not

More information

CCBHCs 101: Opportunities and Strategic Decisions Ahead

CCBHCs 101: Opportunities and Strategic Decisions Ahead CCBHCs 101: Opportunities and Strategic Decisions Ahead Rebecca C. Farley, MPH National Council for Behavioral Health Speaker Name Title Organization It Passed! The largest federal investment in mental

More information

Supporting a Participant Through a Hospitalization Stay: Discharge Planning

Supporting a Participant Through a Hospitalization Stay: Discharge Planning Supporting a Participant Through a Hospitalization Stay: Discharge Planning Disclosure The information that will be shared within today s training are collective ideas gathered from experience, current

More information

Corporate Reimbursement Policy Telehealth

Corporate Reimbursement Policy Telehealth Corporate Reimbursement Policy Telehealth File Name: Origination: Last Review Next Review: telehealth 11/1997 12/2017 12/2018 Description Telehealth is a potentially useful tool that, if employed appropriately,

More information

March Data Jam: Using Data to Prepare for the MACRA Quality Payment Program

March Data Jam: Using Data to Prepare for the MACRA Quality Payment Program March Data Jam: Using Data to Prepare for the MACRA Quality Payment Program Elizabeth Arend, MPH Quality Improvement Advisor National Council for Behavioral Health CMS Change Package: Primary and Secondary

More information

Finding Clarity in the Midst of Uncertainty

Finding Clarity in the Midst of Uncertainty Using Technology to Improve Outcomes for Patients-Part II: Discussion and Case Study Sandra Vale, M.D. Adult Behavioral Health Medical Director The Center for Health Care Services Finding Clarity in the

More information

Pharmacists Improve Care Through Team Collaboration

Pharmacists Improve Care Through Team Collaboration Pharmacists Improve Care Through Team Collaboration Trista Pfeiffenberger, PharmD, MS Director, Network Pharmacy Programs Community Care of North Carolina Disclosure and Conflict of Interest I am an employee

More information

Home Health Quality Improvement Campaign

Home Health Quality Improvement Campaign Home Health Quality Improvement Campaign Description of Monthly Report for Improvement in Oral Medications Monthly Report for Improvement in Management of Oral Medications All data displayed illustrate

More information

Population Health Management Tools and Strategies to Support Care Coordination An InfoMC White Paper April 2016

Population Health Management Tools and Strategies to Support Care Coordination An InfoMC White Paper April 2016 Population Health Management Tools and Strategies to Support Care Coordination An InfoMC White Paper April 2016 Norris, Susan, Ph.D., Chief Clinical Officer, InfoMC Daniels, Allen S., Ed.D., Clinical Director,

More information

ALABAMA MEDICAID AGENCY ADMINISTRATIVE CODE CHAPTER 560-X-5 PSYCHIATRIC FACILITIES FOR INDIVIDUALS 65 OR OVER TABLE OF CONTENTS

ALABAMA MEDICAID AGENCY ADMINISTRATIVE CODE CHAPTER 560-X-5 PSYCHIATRIC FACILITIES FOR INDIVIDUALS 65 OR OVER TABLE OF CONTENTS Medicaid Chapter 560-X-5 ALABAMA MEDICAID AGENCY ADMINISTRATIVE CODE CHAPTER 560-X-5 PSYCHIATRIC FACILITIES FOR INDIVIDUALS 65 OR OVER TABLE OF CONTENTS 560-X-5-.01 560-X-5-.02 560-X-5-.03 560-X-5-.04

More information

Confronting the Challenges of Rare Disease:

Confronting the Challenges of Rare Disease: Confronting the Challenges of Rare Disease: SOLUTIONS ACROSS THE ENTIRE PRODUCT LIFE CYCLE The Orphan Drug Act of 1983 brought increased awareness to the need for new treatments for rare disease patients

More information

Family & Children s Services. Center

Family & Children s Services. Center Family & Children s Services CrisisCare Center When severe psychiatric crisis makes daily life seem impossible, Family & Children s Services new CrisisCare Center can help. Services are available around

More information

Minutes of the Bureau of Health Provider Standards/ Medical Directors Advisory Committee Meeting July 27, 2012

Minutes of the Bureau of Health Provider Standards/ Medical Directors Advisory Committee Meeting July 27, 2012 Minutes of the Bureau of Health Provider Standards/ Medical Directors Advisory Committee Meeting July 27, 2012 ATTENDEES: James Yates, MD, CMD, President Elect Regina Harrell, MD, CMD, Secretary/Treasurer

More information

POLICY. Use of Antipsychotic Medications in Nursing Facility Residents. Preamble. Background

POLICY. Use of Antipsychotic Medications in Nursing Facility Residents. Preamble. Background Preamble POLICY Use of Antipsychotic Medications in Nursing Facility Residents The Office of Inspector General of the U. S. Department of Health and Human Services issued a report in May 2011 finding that

More information

Overview of Presentation

Overview of Presentation End-of-Life Issues: The Role of Hospice in The Nursing Home Susan C. Miller, Ph.D. Center for Gerontology & Health Care Research BROWN MEDICAL SCHOOL Overview of Presentation The rationale for the Medicare

More information

NOVARTIS ONCOLOGY SERVICE REQUEST

NOVARTIS ONCOLOGY SERVICE REQUEST Patient First Name Patient Last Name Patient of Birth NOVARTIS ONCOLOGY SERVICE REQUEST FORM FOR PATIENT SUPPORT For more information, please call 1-800-282-7630 from 9:00 am to 8:00 pm ET, Monday through

More information

Medicaid Update Special Edition Budget Highlights New York State Budget: Health Reform Highlights

Medicaid Update Special Edition Budget Highlights New York State Budget: Health Reform Highlights Page 1 of 6 New York State April 2009 Volume 25, Number 4 Medicaid Update Special Edition 2009-10 Budget Highlights David A. Paterson, Governor State of New York Richard F. Daines, M.D. Commissioner New

More information

Mental Health Services Provided in Specialty Mental Health Organizations, 2004

Mental Health Services Provided in Specialty Mental Health Organizations, 2004 Mental Health Services Provided in Specialty Mental Health Organizations, 2004 Mental Health Services Provided in Specialty Mental Health Organizations, 2004 U.S. Department of Health and Human Services

More information

Please feel free to send thoughts to: We hope you enjoy this. Karl Steinkraus

Please feel free to send thoughts to: We hope you enjoy this. Karl Steinkraus Maryland enewsletter May 2016 Welcome to the new Beacon Maryland Newsletter Beacon Health Options has designed this new quarterly publication to assist providers in getting the news out to the Maryland

More information

Partnership Assessment Tool for Health: Bridging Health Care & Community-Based Human Services

Partnership Assessment Tool for Health: Bridging Health Care & Community-Based Human Services Nonprofit Finance Fund Partnership Assessment Tool for Health: Bridging Health Care & Community-Based Human Services Presentation to Center for Care Innovations Safety Net Innovations Network May 3, 2018

More information

NOVARTIS ONCOLOGY SERVICE REQUEST

NOVARTIS ONCOLOGY SERVICE REQUEST NOVARTIS ONCOLOGY SERVICE REQUEST FORM (CONT) Patient First Name Patient Last Name Patient of Birth NOVARTIS ONCOLOGY SERVICE REQUEST 5. PRESCRIPTION INFORMATION (TO BE COMPLETED BY PRESCRIBER) FORM FOR

More information

Articles of Importance to Read: UnitedHealthcare Goes Live With 13th Edition of Milliman Care Guidelines. Summer 2009

Articles of Importance to Read: UnitedHealthcare Goes Live With 13th Edition of Milliman Care Guidelines. Summer 2009 Important information for physicians and other health care professionals and facilities serving UnitedHealthcare Medicaid members Summer 2009 UnitedHealthcare Goes Live With 13th Edition of Milliman Care

More information

2) The percentage of discharges for which the patient received follow-up within 7 days after

2) The percentage of discharges for which the patient received follow-up within 7 days after Quality ID #391 (NQF 0576): Follow-Up After Hospitalization for Mental Illness (FUH) National Quality Strategy Domain: Communication and Care Coordination 2018 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY

More information

The MetroHealth System

The MetroHealth System The MetroHealth System June 16, 2016 Presentation to Ohio Joint Medicaid Oversight Committee Dr. James Misak, Vice Chair of Community and Population Health, Department of Family Medicine Susan Mego, Executive

More information

Evaluation of Pharmacy Delivery Models

Evaluation of Pharmacy Delivery Models Evaluation of Pharmacy Delivery Models As Required By House Bill 1, 84th Legislature, Regular Session, 2015 (Article II, Health and Human Services Commission, Rider 83) Health and Human Services Commission

More information

Telemedicine Reimbursement. An Overview for Oregon

Telemedicine Reimbursement. An Overview for Oregon Telemedicine Reimbursement An Overview for Oregon A Brief History - Medicare In 1997 the Balanced Budget Act first authorized Medicare to reimburse for telemedicine services Since 2000 there have been

More information

How can we provide the same world class care to patients with psychiatric disorders? 11/27/2016. Dec 2016 Orlando, FL

How can we provide the same world class care to patients with psychiatric disorders? 11/27/2016. Dec 2016 Orlando, FL The presenters have nothing to disclose Transforming Emergency Psychiatry Karen Murrell, MD, MBA, FACEP Physician Lead-Emergency Medicine, Kaiser Northern California Assistant Physician in Chief- Hospital

More information

WYOMING MEDICAID PROVIDER MANUAL. Medical Services HCFA-1500

WYOMING MEDICAID PROVIDER MANUAL. Medical Services HCFA-1500 WYOMING MEDICAID PROVIDER MANUAL Medical Services HCFA-1500 Medical Services March 01,1999 Table of Contents AUTHORITY... 1-1 Chapter One... 1-1 General Information... 1-1 How the Billing Manual is organized...

More information

The influx of newly insured Californians through

The influx of newly insured Californians through January 2016 Managing Cost of Care: Lessons from Successful Organizations Issue Brief The influx of newly insured Californians through the public exchange and Medicaid expansion has renewed efforts by

More information

PERFORMANCE MEASURE DATE / RESULTS / ANALYSIS FOLLOW-UP / ACTION PLAN

PERFORMANCE MEASURE DATE / RESULTS / ANALYSIS FOLLOW-UP / ACTION PLAN Resident-to-Resident Assaults AIM: To decrease incidents of Resident to Residents assaults by 5% in the Fiscal Year (FY) 2011-2012. MONITORING: Data is collected from all instances in which State of California

More information

Behavioral Health Provider Training: Program Overview & Helpful Information

Behavioral Health Provider Training: Program Overview & Helpful Information Behavioral Health Provider Training: Program Overview & Helpful Information Overview The Passport Behavioral Health Program provides members with access to a full continuum of recovery and resiliency focused

More information

Collaborative Care: Case Study of Integrating Primary Care in a Mental Health Setting Beat Steiner MD MPH Brian Sheitman MD

Collaborative Care: Case Study of Integrating Primary Care in a Mental Health Setting Beat Steiner MD MPH Brian Sheitman MD Collaborative Care: Case Study of Integrating Primary Care in a Mental Health Setting Beat Steiner MD MPH Professor of Family Medicine UNC School of Medicine & Associate Medical Director Primary Care Services

More information

Paying for Value and Aligning with Other Purchasers

Paying for Value and Aligning with Other Purchasers Paying for Value and Aligning with Other Purchasers NAMD Bootcamp, Lake Tahoe, May 18, 2014 Dianne Hasselman, Director, Value Based Purchasing, Center for Health Care Strategies Deidre Gifford, MD, Medicaid

More information

Social Determinants of Health: Advocating on behalf of our patients

Social Determinants of Health: Advocating on behalf of our patients Social Determinants of Health: Advocating on behalf of our patients MONICA BHAREL, MD, MPH CHIEF MEDICAL OFFICER BOSTON HEALTH CARE FOR THE HOMELESS PROGRAM Case Study: Boston in the setting of Massachusetts

More information

Hospital Compare Preview Report Help Guide

Hospital Compare Preview Report Help Guide Hospital Compare Preview Report Help Guide Inpatient Psychiatric Facility Quality Reporting Program The target audience for this publication is hospitals participating in the Inpatient Psychiatric Facility

More information

Indiana Hospital Assessment Fee -- DRAFT

Indiana Hospital Assessment Fee -- DRAFT Indiana Hospital Assessment Fee -- DRAFT September 27, 2011 Inpatient Fee The initial Indiana Inpatient Hospital Fee applies to inpatient days from each hospital's most recent FYE as taken from the cost

More information

Provider Orientation to Magellan s Outpatient Behavioral Health Model

Provider Orientation to Magellan s Outpatient Behavioral Health Model Provider Orientation to Magellan s Outpatient Behavioral Health Model July 2017 Big-picture objectives Magellan Healthcare s outpatient care management model: Reduces provider administrative tasks Expedites

More information

Organizations. The Bridge to. Accountable Care ACO. Executive Summary ACOs: The Foundation to Boost Quality and Reduce Costs.

Organizations. The Bridge to. Accountable Care ACO. Executive Summary ACOs: The Foundation to Boost Quality and Reduce Costs. January 2011 2010 ASBPE GOLD 2010 ASBPE GOLD The Bridge to Accountable Care Organizations DIGITAL MAGAZINE DIGITAL MAGAZINE GENERAL EXCELLENCE GENERAL EXCELLENCE ACO Executive Summary ACOs: The Foundation

More information

Pfizer Patient Assistance Program: Instructions for Group D Enrollment Form

Pfizer Patient Assistance Program: Instructions for Group D Enrollment Form Pfizer Patient Assistance Program: Instructions for Group D Enrollment Form This enrollment form is for patients who would like to apply to receive Lyrica (pregabalin) or Lyrica CR (pregabalin) extended

More information

Meeting the Needs of People With Mental Illness Psychiatric Mental Health Nurse Practitioners

Meeting the Needs of People With Mental Illness Psychiatric Mental Health Nurse Practitioners Meeting the Needs of People With Mental Illness Psychiatric Mental Health Nurse Practitioners By JEFFERY RAMIREZ, PhD, PMHNP The passage of the Affordable Care Act in 2010 gives millions of U.S. citizens

More information

Measure #130 (NQF 0419): Documentation of Current Medications in the Medical Record National Quality Strategy Domain: Patient Safety

Measure #130 (NQF 0419): Documentation of Current Medications in the Medical Record National Quality Strategy Domain: Patient Safety Measure #130 (NQF 0419): Documentation of Current Medications in the Medical Record National Quality Strategy Domain: Patient Safety 2017 OPTIONS FOR INDIVIDUAL MEASURES: CLAIMS ONLY MEASURE TYPE: Process

More information

Evolving Roles of Pharmacists: Integrating Medication Management Services

Evolving Roles of Pharmacists: Integrating Medication Management Services Evolving Roles of Pharmacists: Integrating Management Services Marie Smith, PharmD, FNAP Palmer Professor and Assistant Dean, Practice and Policy Partnerships UCONN School of Pharmacy (marie.smith@uconn.edu)

More information

Value-Based Care Emergent Care Services. Presented by Cliff Frank Partnera Partners LLC

Value-Based Care Emergent Care Services. Presented by Cliff Frank Partnera Partners LLC Value-Based Care Emergent Care Services Presented by Cliff Frank Partnera Partners LLC Problem Un-doctored consumers are driving $575 billion inappropriate emergent care Fee-for-service ER visits add another

More information

Billing, Coding and Reimbursement Guide

Billing, Coding and Reimbursement Guide Billing, Coding and Reimbursement Guide Revised June 2016 Disclaimer: The information in this document has been compiled for your convenience and is not intended to provide specific coding or legal advice.

More information

How to Reshape Your Approach to NOWS, Today

How to Reshape Your Approach to NOWS, Today How to Reshape Your Approach to NOWS, Today Adam Czynski, DO Assistant Professor of Pediatrics Warren Alpert Medical School Brown University Director, Newborn Nursery Clinical Neonatologist Women & Infants

More information

The Centers for Medicare & Medicaid Services (CMS) Partnership to Improve Dementia Care

The Centers for Medicare & Medicaid Services (CMS) Partnership to Improve Dementia Care The Centers for Medicare & Medicaid Services (CMS) Partnership to Improve Dementia Care Ohio Psychotropic Medication Nursing Facility Quality Improvement Project Ohio KePRO Nursing Home Quality Care Collaborative

More information

VSHP/ Behavioral Health

VSHP/ Behavioral Health VSHP/ Behavioral Health Deb Dukes & Dr Kelly Askins The contact numbers in the presentation apply to WEST Member Services ONLY. New numbers for EAST Member Services will be published and distributed by

More information

Executive, Legislative & Regulatory 2018 AGENDA. unitypoint.org/govaffairs

Executive, Legislative & Regulatory 2018 AGENDA. unitypoint.org/govaffairs Executive, Legislative & Regulatory 2018 AGENDA unitypoint.org/govaffairs Dear Policy Makers and Community Stakeholders, In the midst of tumultuous times, we bring you our 2018 State Legislative Agenda.

More information

Widespread prescribing, distribution and availability of naloxone for high risk individuals and as rescue medication 2

Widespread prescribing, distribution and availability of naloxone for high risk individuals and as rescue medication 2 Co Occurring Collaborative Serving Maine Expanding Medication Assisted Recovery Services & Building a Stronger Recovery Oriented System for SUD Treatment in Maine April 2018 Introduction: With support

More information

Administrative Update: How to Implement Discharge Pharmacy Services (DPS) Objectives

Administrative Update: How to Implement Discharge Pharmacy Services (DPS) Objectives Administrative Update: How to Implement Discharge Pharmacy Services (DPS) Morgan Pendleton, PharmD, BCOP Hematology/Oncology Clinical Pharmacist Wake Forest Baptist Health Objectives Evaluate the need

More information

Behavioral Health Integration in the Primary Care Setting

Behavioral Health Integration in the Primary Care Setting Behavioral Health Integration in the Primary Care Setting Rajvee Vora, MD,MS Director, Ambulatory Behavioral Health for DSRIP Implementation Health Solutions, Northwell Health Assistant Professor, Department

More information

Updated Only for Logo and Branding Provider Notice

Updated Only for Logo and Branding Provider Notice Updated Only for Logo and Branding Provider Notice To: From: PerformCare Network Providers Sheryl M. Swanson, MBA, Project Manager Date: December 21, 2012 Subject: AD12 112 2013 CPT Code Update IMPLEMENTATION

More information

Johnson City Community Health Center and Treating the Uninsured Mentally Ill

Johnson City Community Health Center and Treating the Uninsured Mentally Ill Johnson City Community Health Center and Treating the Uninsured Mentally Ill Sarah T. Melton, PharmD,BCPP,BCACP,CGP,FASCP Associate Professor Gatton College of Pharmacy Disclosure Statement of Financial

More information

The Medicare Prospective Payntent Systent

The Medicare Prospective Payntent Systent The Medicare Prospective Payntent Systent (Medicare, occupational therapy, prospective payment systems, third party reimbursement) Susan J. Scott In 1983 Congress adopted the most significant change in

More information

Understanding the Referral Criteria and Process to MH/SUD Care Coordination

Understanding the Referral Criteria and Process to MH/SUD Care Coordination Understanding the Referral Criteria and Process to MH/SUD Care Coordination Overview of Alliance MH/SUD Care Coordination What is MH/SUD Care Coordination? What is the Eligibility Criteria for Care Coordination?

More information

Medicaid Electronic Health Record (EHR) Incentive Program:

Medicaid Electronic Health Record (EHR) Incentive Program: Medicaid Electronic Health Record (EHR) Incentive Program: A Webinar for Eligible Hospitals Presenters Yvonne Sanchez, HHSC Craig Earls, CGI February 10, 2011 Overview of EHR Incentive Program Rules and

More information

Janssen Policy Evaluating and Responding to Pre-approval Access Requests for Investigational Medicines

Janssen Policy Evaluating and Responding to Pre-approval Access Requests for Investigational Medicines Janssen Policy Evaluating and Responding to Pre-approval Access Requests for Investigational Medicines PURPOSE This policy establishes the principles by which the Janssen Pharmaceutical Companies of Johnson

More information

Florida Medicaid. State Mental Health Hospital Services Coverage Policy. Agency for Health Care Administration. January 2018

Florida Medicaid. State Mental Health Hospital Services Coverage Policy. Agency for Health Care Administration. January 2018 Florida Medicaid State Mental Health Hospital Services Coverage Policy Agency for Health Care Administration Table of Contents 1.0 Introduction... 1 1.1 Description... 1 1.2 Legal Authority... 1 1.3 Definitions...

More information

2015 Member Incentive. Program Evaluation. Our mission is to improve the health and quality of life of our members

2015 Member Incentive. Program Evaluation. Our mission is to improve the health and quality of life of our members 25 Member Incentive Program Evaluation Our mission is to improve the health and quality of life of our members 25 Member Incentive Program Evaluation Annual Participation Rate Program Title: Member Incentive

More information

cousins asking for help.

cousins asking for help. tance. (See sidebar, page 48.) However, such breakthroughs depend upon communications advances taken for granted in metropolitan areas. Cell phone service and broadband access are available on only a spotty

More information

NCL MEDICATION ADHERENCE CAMPAIGN FREQUENTLY ASKED QUESTIONS 2013

NCL MEDICATION ADHERENCE CAMPAIGN FREQUENTLY ASKED QUESTIONS 2013 NCL MEDICATION ADHERENCE CAMPAIGN FREQUENTLY ASKED QUESTIONS 2013 1. WHAT EXACTLY IS MEDICATION ADHERENCE? Adhering to medication means taking the medication as directed by a health care professional-

More information

Observation vs. Inpatient: How to Get it Right. November 5, 2013

Observation vs. Inpatient: How to Get it Right. November 5, 2013 Observation vs. Inpatient: How to Get it Right November 5, 2013 Learning Objectives Understand how the Inpatient Prospective Payment System (IPPS) Final Rule impacts your facility Integrate leading practice

More information

Transition of Care Practices. Nancy MacDonald, PharmD, BCPS, FASHP Henry Ford Hospital Detroit, MI

Transition of Care Practices. Nancy MacDonald, PharmD, BCPS, FASHP Henry Ford Hospital Detroit, MI Transition of Care Practices Nancy MacDonald, PharmD, BCPS, FASHP Henry Ford Hospital Detroit, MI Objectives Pharmacist 1. Describe transition of care opportunities 2. Explain ways to use pharmacist extenders

More information

Welcome to the Agency for Health Care Administration (AHCA) Training Presentation for Managed Medical Assistance Specialty Plans

Welcome to the Agency for Health Care Administration (AHCA) Training Presentation for Managed Medical Assistance Specialty Plans Welcome to the Agency for Health Care Administration (AHCA) Training Presentation for Managed Medical Assistance Specialty Plans The presentation will begin momentarily. Please dial in to hear audio: 1-888-670-3525

More information

Statewide Medicaid Managed Care Long-term Care Program Coverage Policy

Statewide Medicaid Managed Care Long-term Care Program Coverage Policy Statewide Medicaid Managed Care Long-term Care Program Coverage Policy Coverage Policy Review June 16, 2017 Today s Presenters D.D. Pickle, AHC Administrator 2 Objectives Provide an overview of the changes

More information

Medicaid Efficiency and Cost-Containment Strategies

Medicaid Efficiency and Cost-Containment Strategies Medicaid Efficiency and Cost-Containment Strategies Medicaid provides comprehensive health services to approximately 2 million Ohioans, including low-income children and their parents, as well as frail

More information

III. HOW NURSING FACILITIES ARE FUNDED

III. HOW NURSING FACILITIES ARE FUNDED III. HOW NURSING FACILITIES KEY POINTS Today, nursing and rehabilitation facilities are funded through four sources: Medicare, Medicaid, Quality Assurance Assessment Program and patient pay. Medicare Part

More information

4. Program Regulations

4. Program Regulations Table of Contents LAB-35 iv 04/01/10 401.401: Introduction... 4-1 401.402: Definitions... 4-1 401.403: Eligible Members... 4-2 401.404: Provider Eligibility... 4-2 401.405: Laboratory Services Provided

More information

Bridging the Gap Between Crisis and Care: How to Effectively Integrate Psychiatric Emergency Care Within a Community Hospital Emergency Department.

Bridging the Gap Between Crisis and Care: How to Effectively Integrate Psychiatric Emergency Care Within a Community Hospital Emergency Department. Bridging the Gap Between Crisis and Care: How to Effectively Integrate Psychiatric Emergency Care Within a Community Hospital Emergency Department. Jeannine Loucks, MSN, RN BC PMHN Laura Derr, BSN, RN

More information

Caregivers of Adults with Severe Mental Illness: Results of a National Study

Caregivers of Adults with Severe Mental Illness: Results of a National Study Caregivers of Adults with Severe Mental Illness: Results of a National Study Gail Hunt, President & CEO National Alliance for Caregiving Angela Kimball, National Director of Advocacy & Public Policy National

More information

Maryland. Center for Connected Health Policy. Medicaid Program: MD Medical Assistance Program. Program Administrator: MD Dept. of Social Services

Maryland. Center for Connected Health Policy. Medicaid Program: MD Medical Assistance Program. Program Administrator: MD Dept. of Social Services Maryland Medicaid Program: MD Medical Assistance Program Program Administrator: MD Dept. of Social Services Regional Telehealth Resource Center Mid-Atlantic Telehealth Resource Center PO Box 800711 Charlottesville,

More information

Medicaid Practice Benchmark Report

Medicaid Practice Benchmark Report Issue Brief Medicaid Practice Benchmark Report Overview In 2015, the Maine Health Management Coalition (MHMC) distributed its first Medicaid Practice Benchmark Report to over 300 pediatric and adult practices,

More information

Submitting Inpatient Rehabilitation Requests for Authorization

Submitting Inpatient Rehabilitation Requests for Authorization Submitting Inpatient Rehabilitation Requests for Authorization Keys to Success Clinical Webinar for Acute Inpatient Rehabilitation Objectives State the purpose of acute inpatient rehabilitation authorizations

More information

Overall Learning Objectives How large is the specialty pharmaceutical market? Drug Trends Source: CVS Caremark 2013 Drug Trend Focus Report

Overall Learning Objectives How large is the specialty pharmaceutical market? Drug Trends Source: CVS Caremark 2013 Drug Trend Focus Report What s So Special About Specialty Pharmacies? Overview and Role of Pharmacists and Pharmacy Technicians Implementation of a Specialty Pharmacy Program Overall Learning Objectives For Pharmacists and Pharmacy

More information

Medicaid 101: The Basics for Homeless Advocates

Medicaid 101: The Basics for Homeless Advocates Medicaid 101: The Basics for Homeless Advocates July 29, 2014 The Source for Housing Solutions Peggy Bailey CSH Senior Policy Advisor Getting Started Things to Remember: Medicaid Agency 1. Medicaid is

More information

HEALTH CARE TEAM SACRAMENTO S MENTAL HEALTH CRISIS

HEALTH CARE TEAM SACRAMENTO S MENTAL HEALTH CRISIS Team Leader/Issue Contact: HEALTH CARE TEAM Laura Niznik Williams, UC Davis Health System, (916) 276-9078, ljniznik@ucdavis.edu SACRAMENTO S MENTAL HEALTH CRISIS Requested Action: Evaluate the Institutions

More information

From Free Drug to Paid Prescriptions: PATIENT ASSISTANCE STRATEGIES TO ENSURE ROI. by Jan Nielsen, Division President, SonexusHealth

From Free Drug to Paid Prescriptions: PATIENT ASSISTANCE STRATEGIES TO ENSURE ROI. by Jan Nielsen, Division President, SonexusHealth From Free Drug to Paid Prescriptions: PATIENT ASSISTANCE STRATEGIES TO ENSURE ROI by Jan Nielsen, Division President, SonexusHealth The Role of Patient Assistance Programs Healthcare affordability is reaching

More information

Session 6 PD, Mitigating the Cost Impact of Trends in Hospital Billing Practices. Moderator/Presenter: Sabrina H.

Session 6 PD, Mitigating the Cost Impact of Trends in Hospital Billing Practices. Moderator/Presenter: Sabrina H. Session 6 PD, Mitigating the Cost Impact of Trends in Hospital Billing Practices Moderator/Presenter: Sabrina H. Gibson, FSA, MAAA Presenters: Dawna Nibert Lawrence R. Smart, FSA, MAAA Society of Actuaries

More information

Mental Health Crisis in the Emergency Department - PsychED

Mental Health Crisis in the Emergency Department - PsychED Mental Health Crisis in the Emergency Department - PsychED Dr Megan Fisher ST4 Child and Adolescent Psychiatry Trainee Fellow in Medical Education at Maudsley Simulation Remember to tweet about your favourite

More information

SECTION V. HMO Reimbursement Methodology

SECTION V. HMO Reimbursement Methodology SECTION V. HMO Reimbursement Methodology Overview V-2 SFHN s Financial Responsibility Provider Payment Methodology Chart Primary Care Physicians V-4 Overview Capitated Primary Care Services Services Reimbursed

More information

Medicaid and Free Care Opportunities for Covering Services in Schools

Medicaid and Free Care Opportunities for Covering Services in Schools Medicaid and Free Care Opportunities for Covering Services in Schools Healthy Homes, Schools, and Communities Health Determinants of Early School Success: Leveraging Medicaid for Impact Sarah Somers, Managing

More information

Behavioral Health Provider Training: Program Overview & Helpful Information

Behavioral Health Provider Training: Program Overview & Helpful Information Behavioral Health Provider Training: Program Overview & Helpful Information Overview The Passport Behavioral Health Program provides members with access to a full continuum of recovery and resiliency focused

More information

BlueOptions - Healthy Rewards HRA Plan

BlueOptions - Healthy Rewards HRA Plan BlueOptions - Healthy Rewards HRA Plan Schedule of Benefits Plan 03359 Important things to keep in mind as you review this Schedule of Benefits: This Schedule of Benefits is part of your Benefit Booklet,

More information

Medication Adherence: Strategies for Improving Outcomes

Medication Adherence: Strategies for Improving Outcomes Medication Adherence: Strategies for Improving Outcomes Thursday, June 16, 2016, 12:00 p.m. to 1:00 p.m. Andrea H. Williams, RPh, MBA President, RX CONSULTANTS LLC, Wilmington, DE EDUCATIONAL OBJECTIVES

More information

Pediatric Population Health

Pediatric Population Health JANUARY 25, 2018 Swedish Pediatric CME 2018 Pediatric Population Health Michael Dudas, MD Chief of Pediatrics, Virginia Mason Medical Center Co-Chair, Health Care Transformation Committee, WCAAP 1 Objectives

More information

Acute Crisis Units. Shelly Rhodes, Provider Relations Manager

Acute Crisis Units. Shelly Rhodes, Provider Relations Manager Acute Crisis Units Shelly Rhodes, Provider Relations Manager Shelly.Rhodes@beaconhealthoptions.com Training Agenda Agenda: Transition and Certification Coverage of Services Service Code Definition Documentation

More information

LINKING AND ALIGNING CARE COORDINATION PLAN

LINKING AND ALIGNING CARE COORDINATION PLAN LINKING AND ALIGNING CARE COORDINATION PLAN Project BLOOM is an early childhood mental health system of care grant that is funded by the Substance Abuse Mental Health Services Agency and administered by

More information

Decreasing Medical. Costs. Are your members listening to you? PRESENTED BY: September 22, 2016

Decreasing Medical. Costs. Are your members listening to you? PRESENTED BY: September 22, 2016 Decreasing Medical Costs Are your members listening to you? PRESENTED BY: Aaron Crowell, Executive Vice President, MTM, Inc. Gary Jacobs, Executive Vice President, CareCentrix Dan Masciopinto, SVP of Product,

More information

5D QAPI from an Operational Approach. Christine M. Osterberg RN BSN Senior Nursing Consultant Pathway Health Pathway Health 2013

5D QAPI from an Operational Approach. Christine M. Osterberg RN BSN Senior Nursing Consultant Pathway Health Pathway Health 2013 5D QAPI from an Operational Approach Christine M. Osterberg RN BSN Senior Nursing Consultant Pathway Health Objectives Review the post-acute care data agenda. Explain QAPI principles Describe leadership

More information

Banner Health Friday, February 20, 2015

Banner Health Friday, February 20, 2015 Banner Health Friday, February 20, 2015 Leveraging the Power of Clinical and Business Intelligence: A Primer Presented by: Dr. Maxine Rand, DNP, RN-BC, CPHIMS, Director, Clinical Education, Practice and

More information

HCCA South Central Regional Annual Conference November 21, 2014 Nashville, TN. Post Acute Provider Specific Sections from OIG Work Plans

HCCA South Central Regional Annual Conference November 21, 2014 Nashville, TN. Post Acute Provider Specific Sections from OIG Work Plans HCCA South Central Regional Annual Conference November 21, 2014 Nashville, TN Kelly Priegnitz # Chris Puri # Kim Looney Post Acute Provider Specific Sections from 2012-2015 OIG Work Plans I. NURSING HOMES

More information

Physical Health Integration Within Behavioral Healthcare: Promising Practices

Physical Health Integration Within Behavioral Healthcare: Promising Practices Physical Health Integration Within Behavioral Healthcare: Promising Practices 9:45 AM 10:45 AM Steering Toward Success: Achieving Value in Whole Person Care September 25 and October 26, 2017 The Healthier

More information

Transforming Healthcare Delivery, the Challenges for Behavioral Health

Transforming Healthcare Delivery, the Challenges for Behavioral Health Transforming Healthcare Delivery, the Challenges for Behavioral Health Presented by: M.T.M. Services, LLC P. O. Box 1027, Holly Springs, NC 27540 Phone: 919-434-3709 Fax: 919-773-8141 E-mail: mtmserve@aol.com

More information

PRECERTIFICATION/AUTHORIZATION OF TREATMENT

PRECERTIFICATION/AUTHORIZATION OF TREATMENT PRECERTIFICATION/AUTHORIZATION OF TREATMENT EAP Treatment It is the policy of IEAP to use an EAP session for the initial assessment whenever possible. If IEAP only manages EAP services for a particular

More information

The Future of Pharma: Patients Rising to the Core

The Future of Pharma: Patients Rising to the Core The Future of Pharma: Patients Rising to the Core Jyotirmay Datta Vice President and Global Industry Head for Medical Devices, Wipro Limited Nitin Raizada GM, Industry Solutions Group, Lifesciences, Wipro

More information