Health HAPPEN. Make. Prepare now to stay healthy during flu season. Inside
|
|
- Alannah Warner
- 5 years ago
- Views:
Transcription
1 Inside How to lower your blood pressure Make Health HAPPEN Quarter 3, Prepare now to stay healthy during flu season Influenza, also known as the flu, can make you feel terrible. But there are things you can do now to help keep the flu away. Some basic tips: Get a flu vaccine, or shot, each year. Wash your hands often. Stay away from people who have the flu. Eat more foods like fruits and vegetables that can help protect you from the flu. Drink more water. Get more rest. When should you get a flu shot? Even though the flu season usually peaks in January or later, try to get a flu shot as soon as the vaccine becomes available before the flu season even begins and reaches your community. This will give your body time to develop the antibodies needed to protect against the flu. Where can you get a flu shot or more information? Your primary care provider (PCP) or case manager Any of our network pharmacies if you re age 21 or older Your local health department The Centers for Disease Control and Prevention (CDC) recommends everyone 6 months and older, especially those at high risk of serious complications from the flu, get a flu shot every year. If you re age 65 or older, the CDC suggests getting a pneumonia vaccine as needed. How active is the flu in your state or city? Visit cdc.gov/flu/weekly for more details. Member Services (TTY 711) 8 a.m.-8 p.m. local time 7 days a week 24-hour Nurse HelpLine (TTY 711) HMM-NL MUSENAGP
2 Be a nutrition detective to help keep your blood pressure in check It s normal to feel overwhelmed when you ve been told you have hypertension, or high blood pressure. But there are small changes you can make to help lower your blood pressure and improve your quality of life. Question: The diet for lowering blood pressure seems so complicated. What can I do to make it simpler? Answer: First, take a look at your eating habits. Keep a food journal for a few days and then be a detective: Look for foods you know are high in sodium and consider changing them to lower sodium items. If you re not sure of the sodium content, take a look at the nutrition labels on the foods you eat. What are some of your favorite fruits and vegetables? What are some ways you could increase the amount you eat? Consider eating smaller portions of the foods you eat. Diane, a registered dietitian nutritionist at Amerigroup, shares how being a nutrition detective can help you control your blood pressure.
3 Next, consider eating the DASH diet. DASH stands for Dietary Approaches to Stop Hypertension. It began as a way to help manage hypertension but also helps prevent heart disease, diabetes and some cancers. The DASH diet: Is low in saturated fat, cholesterol and total fat Focuses on fruits, vegetables and fat-free or low-fat dairy products Is rich in whole grains, fish, poultry, beans, seeds and nuts Contains fewer sweets, added sugars, sugary beverages, red meats and less sodium (salt) For more information on the DASH diet, visit nhlbi.nih.gov/files/docs/public/heart/hbp_low.pdf. Question: How do I cut sodium from my diet? Answer: Most sodium comes from processed foods like hot dogs, luncheon meats, boxed macaroni and cheese, pizza, fast food, restaurant foods, frozen dinners and snack foods such as chips and crackers. Try using roasted meats for sandwiches, preparing foods from fresh ingredients, eating at home more often and using less salt to season food. When eating out, choose lean fish and seafood that s not fried or with sauces, grilled meats and vegetables without sauce or with sauce on the side. Another good tip is to split your meal with someone. Or at the beginning of your meal, put half your food in a to-go container to take home for another meal. Question: Won t the food be tasteless? Answer: You re not alone if you feel this way. Consider using herbs and spices to take the place of salt. Most cookbooks have charts that show which herbs and spices will work best for certain foods. You can also look online for charts and recipes, find low-sodium cookbooks and check a restaurant s menu for low-sodium dishes. Remember, you can still eat some of your favorite foods by limiting the amount and how often you eat them.
4 Committed to excellence Our team s focus is on you at Amerigroup. We want to help you get and stay healthy. We do this through the following programs: Clinical Quality Improvement Program, which consists of the following: Coordination of Care to help you and your providers work together as a team to help you get the care you need when you need it. Improved access and affordability to offer a large network of providers and hospitals to meet all your health care needs. We can help you find who and what you need when you need them. Preventive care to remind you about health screenings and services that can help you get and stay healthy. At times, you may get calls or mail from us to help set up appointments, yearly checkups, and other screenings such as mammograms or a bone density test if you recently broke a bone. We can also send a provider to your home for some routine screenings. Treatment for chronic conditions to provide you with extra help from our nurses who can help you manage your condition at home, including support after a hospital stay that can help reduce your risk of having to go back to the hospital. Clinical Practice Guidelines (CPGs) and Preventive Health Guidelines (PHGs) are recommendations for your providers to help them give you the best possible care for certain health conditions and preventive care. We have a special committee of board-certified and credentialed providers who review the guidelines to help make sure they re up-to-date. If you d like a copy of any CPG or PHG, please call Member Services. Pharmacy programs such as reviewing medications with a pharmacist help make sure the medications you take are safe and effective. A team member may call you to talk about why you may not be taking a drug you were prescribed, send you a letter to offer services and support, or contact your provider to talk about possible changes to your medication. Healthcare Effectiveness Data and Information Set (HEDIS ) is a program developed by the National Committee for Quality Assurance (NCQA) to measure performance on different types of care and service.
5 Consumer Assessment of Healthcare Providers & Systems (CAHPS ) is a survey that asks members how happy they are with their health care, health insurance plan, and providers so the Medicare program can rate the quality and performance of all health insurance and prescription drug plans each year. Some of the areas on the survey that Medicare reviews include how: You rate our plan's services and care Our doctors find illnesses and keep members healthy Our plan helps you use prescribed medications safely Star Ratings also use CAHPS measures. In 2016, more members said: They got appointments and care quickly Their doctors made it easy for them to manage their care It was easy to get services they needed, such as specialist care, lab tests and X-rays They were very happy with the quality of health care they received through the plan They could easily get the prescription drugs they needed using the plan HEDIS and CAHPS results help identify areas of strength and areas where we can improve. For more information about our plan and how it compares to others, visit the website medicare.gov. Quality Improvement Goals to help make sure we re: Getting our members quality health care and services Helping you see your provider for prompt follow-up care after being in the hospital Working to help you improve your health Helping you stay well and manage your health care needs Special Needs Plan (SNP) programs are designed to meet your unique health care needs. Shortly after you enroll in our SNP and every year after you enroll, you ll get a call to complete a health risk assessment (HRA) so we know your health care needs. A nurse will work with you to create a care plan and discuss it with your health care team to help make sure you get the care you need. Case management is just one of the many ways we can help you if you: Have a serious health problem Go to the emergency room a lot See multiple providers Have to go into the hospital often For more information about case management, call the customer service number on your member ID card. Evaluating our program each year is another way to help us improve. We have goals for our SNPs that we monitor and measure often. They include: Having enough providers to meet your needs Effectively reaching out to you to complete an HRA Working with you to create a care plan and health care team that meets your needs Knowing how many members are getting certain preventive care services Getting you follow-up care after you go home from the hospital Making sure you re going to your primary care provider (PCP) While we have met many of the goals, we re currently working to find better ways to: Reach you to complete the HRA Reach you and your provider to participate in care team meetings Help you get the care you need, including vaccinations and other preventive testing Contact you after a hospital stay to help with follow-up care and ways to stay at home Offer case management services and home care providers
6 We report the following HEDIS and other measures on our Special Needs Plans (SNP) every month: Controlling High Blood Pressure (CBP) Care for Older Adults (COA) Medication Review Care for Older Adults (COA) Functional Status Care for Older Adults (COA) Pain Screening Colorectal Cancer Screening (COL) Follow up after hospitalization for mental illness 7 days (FUH-7) Follow up after hospitalization for mental illness 30 days (FUH-30) Osteoporosis Management in Women Who had a Fracture (OMW) Plan All-Cause Readmission (PCR) In 2016, we had overall improvement in seven of nine SNP measures listed above. We have more work to do on two of the measures Controlling High Blood Pressure and Medication Review for Older Adults. We ll keep working to improve these results. The Medicare HEDIS measures we track are listed below: Comprehensive Diabetes Care (CDC) HbA1c testing Breast Cancer Screening (BCS) Colorectal Cancer Screening (COL) Controlling High Blood Pressure (CBP) High Risk Medications (HRM) Medication Adherence for Blood Pressure, Cholesterol and Diabetes Plan All-Cause Readmission (PCR) Medicare health plans get Star Ratings based on how well they perform on these HEDIS measures. The number of stars indicates how well of a job our plan is doing: 5 stars Excellent 4 stars Above average 3 stars Average 2 stars Below average 1 star Poor In 2016, more than 50 percent of our Medicare members were enrolled in health plans with four or more stars. Overall improvement in six out of seven Medicare HEDIS measures listed to the left helped our star rating, but we have more work to do on Controlling High Blood Pressure. We ll continue to check these results often to help improve your care.
7 What can you do to stay as healthy as possible? You may feel overwhelmed at the thought of going to your provider regularly or getting regular tests and screenings, but there are a few things you can do. And our team members are here to help you every step of the way. Put a check beside the things you already do or are willing to start doing. I will: See my PCP if I m not having a medical emergency. He or she is my main doctor and can help coordinate my care with other providers I may have. Complete the HRA when a nurse case manager calls me. Get preventive health care such as flu and pneumonia shots, mammograms, colon cancer screenings, diabetic testing and glaucoma tests. Keep a health journal, write down questions for my provider and take them with me to my appointments. Take a list of my medications to my appointments and go over it with my providers. Take my medicines as my provider prescribed. Be more active but talk to my PCP first about what activities are safe for me. Control my blood pressure and cholesterol. What questions do you have? If you need help, call the toll-free customer service or 24-hour nurse help line numbers listed on your member ID card.
8 P.O. Box Virginia Beach, VA Our Notice of Privacy Practices This type of notice explains how medical information about you may be used and disclosed by Amerigroup. It also tells you how to access this information. The notice follows the privacy regulations set by the Health Insurance Portability and Accountability Act (HIPAA). If you would like a copy of our Notice of Privacy Practices, please call Member Services at the phone number listed on your ID card or visit Make Health HAPPEN newsletter Health and wellness or prevention information Making decisions on care and services Sometimes, we need to make decisions about how we cover care and services. This is called Utilization Management (UM). Our UM process is based on the standards of the National Committee for Quality Assurance (NCQA). All UM decisions are based on medical needs and current benefits only. We do this for the best possible health outcomes for our members. We also don t tell or encourage providers to underuse services. And we don t create barriers to getting health care. Providers do not get any reward for limiting or denying care. And when we decide to hire, promote or fire providers or staff, we don t base it on whether or not we think they might deny or would be likely to deny benefits. Make Health Happen is published by Amerigroup to give information. It is not a way to give personal medical advice. Get medical advice directly from your physician All rights reserved. Printed in the USA. Amerigroup is a Medicare Advantage Organization with a Medicare contract. For Dual-Eligible Special Needs Plans: Amerigroup is a D-SNP with a Medicare Contract and a contract with the state Medicaid program. Enrollment in Amerigroup depends on contract renewal. In New Mexico, Amerigroup is Amerigroup Community Care of New Mexico, Inc. In New Jersey, Amerigroup is Amerivantage Specialty + Rx (HMO SNP). Y0114_17_33299_I_ 10/25/2017 AMV NL-PC-1017 E
Your health comes first
Your health comes first Here are the many ways we re working to ensure the quality of your care At Amerigroup, our focus is on you. We want to help you get and stay healthy. That s why we have many programs
More informationMyHealth. results with your doctor. Talk High. to him or her about how often 3. Eat foods low in saturated 140/90 or higher
2016 MyHealth Quarter 3 Anthem Blue Cross Cal MediConnect Plan What is blood pressure? Blood pressure is the amount of force it takes for your heart to push blood through your body. When your blood pressure
More informationTHANK YOU. Health HAPPEN. Quality work yields quality results. Make. for being a member of Amerigroup Community Care! Inside Gettng the care you need
Inside Gettng the care you need Make Health HAPPEN Vol. 1, 2017 www.myamerigroup.com/md THANK YOU for being a member of Amerigroup Community Care! Every year, we look at how well we re serving you. Then,
More informationHappen Quarter 1, 2013
Amerigroup Community Care MakeHealth Happen Quarter 1, 2013 Screenings that Save Lives Things to know: Learning you are healthy can help bring peace of mind Screenings may help find growths before they
More informationYour Wellness Visit Guide
Your Wellness Visit Guide Prepare for your Annual Wellness Visit or Welcome to Medicare Visit. Let s make the most of your appointment. Annual Wellness Visit Provider Toolkit Caring for Seniors HIGHMARK.COM
More informationHow to go paperless: To sign up, follow these three simple steps: National Medicare Coverage Changes page 7
HealthyYou Medicare Member News Winter 2015 Go paperless! It s quick and easy. Sign up online to receive certain communications electronically, such as: Newsletters Premium invoices Preventive care information
More informationPassport Advantage Provider Manual Section 8.0 Quality Improvement
Passport Advantage Provider Manual Section 8.0 Quality Improvement Table of Contents 8.1 Quality Improvement Program 8.2 Clinical Practice Guidelines 8.3 Star s 8.4 Quality of Care Concerns 8.3 Practitioner
More informationWe Want the Best for You Medicare Diabetes Prevention Program (MDPP) Get Screened for Colorectal Cancer Diabetes & Statin Use
BEWELL Member tips, tools and resources to support a healthy lifestyle Volume 2 2018 We Want the Best for You Medicare Diabetes Prevention Program (MDPP) Get Screened for Colorectal Cancer Diabetes & Statin
More informationAnnual update to your
Annual update to your Amerigroup health plan www.myamerigroup.com/tn Quality work yields quality results At Amerigroup, your health is important to us. We work hard to make sure you have access to great
More informationHappen. The Truth About Antibiotic Use
Amerigroup Community Care MakeHealth Happen Antibiotics kill Bacteria strep throat sinus infections some types of pneumonia NOT viruses common cold the flu The Truth About Antibiotic Use When you feel
More informationMedicare Advantage Star Ratings
Medicare Advantage Star Ratings December 2017 The Star Rating System measures how well Medicare Advantage (MA) and its prescription drug plans perform for consumers. As an integrated health system, Presbyterian
More informationHealth in Handbook. a guide to Medicare rights & health in Pennsylvania #6009-8/07
Health in Handbook a guide to Medicare rights & health in Pennsylvania #6009-8/07 Tips for Staying Healthy works hard to make sure that the health care you receive is the best care possible. There are
More informationPayment Innovations HELP KEEPING YOUR COSTS IN CHECK
Blue Bulletin MEMBER NEWSLETTER Payment Innovations HELP KEEPING YOUR COSTS IN CHECK What s also in this issue: Need to Find a Doctor? We Can Help... Page 5 Make a Plan for Your Health... Page 7 bcidaho.com
More informationWellness Guide for LCRA Retirees
2016 Wellness Guide for LCRA Retirees Contents 2 How the EmPOWER program works 3 How to register 3 Text message reminders 4 Member health assessment 4 Biometric screening 5 Earning points and saving money
More informationBlue Advantage (PPO) SM 2018 Quality+Partnerships
Blue Advantage (PPO) SM 2018 Quality+Partnerships Your Partner in Quality Care BlueCross BlueShield of Tennessee is committed to ensuring our members have access to a network of high quality providers.
More informationMY HEALTH WITH HEALTH CROWD YOU CAN GET IMPORTANT MESSAGES SUMMER 2018
SUMMER 2018 MY HEALTH www.unicare.com/medicaid YOU CAN GET IMPORTANT MESSAGES WITH HEALTH CROWD UniCare Health Plan of West Virginia, Inc. wants to communicate with you in the way that s most convenient
More informationOnsite Clinic and Wellness Programs 2010 VACo Achievement Awards. Montgomery County, VA
Onsite Clinic and Wellness Programs 2010 VACo Achievement Awards Montgomery County, VA 1. Brief overview Montgomery County implemented a fully integrated on site disease management Clinic and Wellness
More informationHouseCalls Objectives
Overview Agenda Overview Objectives Background Case studies Member Experience Primary Care Provider Experience Referrals and Follow-up Influence on Centers for Medicare & Medicaid Services (CMS) Star Ratings
More informationCAHPS : Health Care Quality From Your Point of View
FLORIDA 2017 ISSUE I CAHPS : Health Care Quality From Your Point of View Consumer Assessment of Healthcare Providers and Systems (CAHPS) is a survey. It asks members about the care they received. The survey
More information2018 PROVIDER TOOLKIT
1100 Circle 75 Parkway Suite 1100 Atlanta, GA 30339 2018 PROVIDER TOOLKIT Understanding the Centers for Medicare and Medicaid (CMS) Stars Rating System What is CMS Quality Star Ratings program? CMS evaluates
More informationMedical Management. G.2 At a Glance. G.3 Procedures Requiring Prior Authorization. G.5 How to Contact or Notify Medical Management
G.2 At a Glance G.3 Procedures Requiring Prior Authorization G.5 How to Contact or Notify Medical Management G.6 When to Notify Medical Management G.11 Case Management Services G.14 Special Needs Services
More informationMedical Management. G.2 At a Glance. G.2 Procedures Requiring Prior Authorization. G.3 How to Contact or Notify Medical Management
G.2 At a Glance G.2 Procedures Requiring Prior Authorization G.3 How to Contact or Notify G.4 When to Notify G.7 Case Management Services G.10 Special Needs Services G.12 Health Management Programs G.14
More informationCONTENTS. 4 How to Use the Program. 5 How to Register. 6 Awareness
CONTENTS 4 How to Use the Program 5 How to Register 6 Awareness 7 Earning Points Incentive Programs 8 Wellness Rate Program 9 Healthy Rewards Program 10 Prevention 11 Employer & Peer Challenges 12 Education
More informationQUALITY IMPROVEMENT PROGRAM
QUALITY IMPROVEMENT PROGRAM EmblemHealth s mission is to create healthier futures for our customers and communities. We will do this by providing members with a broad range of benefits and conscientious
More informationSpecial Needs Plan Model of Care Chinese Community Health Plan
Special Needs Plan Model of Care 2017 2017 Chinese Community Health Plan Elements of CCHP SNP Model of Care Special Needs Plan (SNP) Goals CCHP Dual Eligible SNP Enrollment & Eligibility Vulnerable Beneficiaries
More informationStay Current. Our new website is easier to use. - Ease Your Back Pain - How to Save Money - Strong Bones for Life
SUMMER 2010 Stay Current Our new website is easier to use - Ease Your Back Pain - How to Save Money - Strong Bones for Life one TO one newsletter for medicare advantage members friends fly-fishing near
More informationMAKING PROGRESS, SEEING RESULTS
MAKING PROGRESS, SEEING RESULTS VALUE-BASED CARE REPORT HUMANA.COM/VALUEBASEDCARE Y0040_GCHK4DYEN 1117 Accepted 2 Americans are sick and getting sicker, with millions of us living with chronic conditions
More informationAssessing the Quality of California Dual Eligible Demonstration Health Plans
M A Y 2 0 1 2 Assessing the Quality of California Dual Eligible Demonstration Health Plans T A B L E O F C O N T E N T S Overview... 1 Introduction... 2 Table 1: Plan Rating Overview... Summary of Quality
More informationWatch Your Weight, Eat Healthy and Exercise More
SOUTH CAROLINA 2016 ISSUE I Watch Your Weight, Eat Healthy and Exercise More Did you know that South Carolina s adult obesity rate is 31.7%? That makes it the 10th highest adult obesity rate in the nation.
More informationGuide to Accessing Quality Health Care Spring 2017
Guide to Accessing Quality Health Care Spring 2017 MolinaHealthcare.com 5771749DM0217 MyMolina MyMolina is a secure web portal that lets you manage your own health from your computer. MyMolina.com is easy
More informationWhat s on Your Plate?
FALL 2017 A Newsletter for L.A. Care Covered Members What s on Your Plate? Choosing a balanced diet is among the choices you can make to live a healthy lifestyle. A healthy eating plan that helps you manage
More informationWatch Your Weight, Eat Healthy and Move More
ILLINOIS 2016 ISSUE I Watch Your Weight, Eat Healthy and Move More More and more people are overweight and obese. Overweight people are at higher risk for: Heart disease; Diabetes; Arthritis-related conditions;
More informationPINE REST CHRISTIAN MENTAL HEALTH SERVICES COMMUNITY AND RESIDENTIAL SERVICES CENTER FOR PSYCHIATRIC RESIDENTIAL SERVICES. Wellness Policy APPROVAL:
PINE REST CHRISTIAN MENTAL HEALTH SERVICES COMMUNITY AND RESIDENTIAL SERVICES CENTER FOR PSYCHIATRIC RESIDENTIAL SERVICES Wellness Policy Departmental Policy: Date of Original Document: March 2016 Date
More information1. What is your ethnic origin? (Check one) 2. What is your gender? 3. What is your age? Page 1. nmlkj. nmlkj. nmlkj. nmlkj. nmlkj. nmlkj. nmlkj.
1. What is your ethnic origin? (Check one) White Asian/Pacfic Island American Indian Black Hispanic 2. What is your gender? Female Male 3. What is your age? 18 to 24 55 to 64 25 to 34 65 to 74 35 to 44
More informationWe Want the Best for You Sexually Transmitted Diseases (STDs): > Reduce Your Risk
BEWELL Member tips, tools and resources to support a healthy lifestyle Volume 2 2018 We Want the Best for You Sexually Transmitted Diseases (STDs): > Reduce Your Risk Reminder About HPV Vaccination Diabetes
More informationMAKE THE MOST OF YOUR EMBLEMHEALTH PLAN
MAKE THE MOST OF YOUR EMBLEMHEALTH PLAN a Thank you for renewing your health insurance coverage with EmblemHealth! We value your membership. We want to give you and your family the highest level of service
More informationWELLNESS INTEREST SURVEY RESULTS Skidmore College
WELLNESS INTEREST SURVEY RESULTS Skidmore College March 22, 2016 2016 MVP Health Care, Inc. DEMOGRAPHICS 474 surveys collected GENDER AGE Prefer not to disclose 7 1% No Answer 54 11% Male 112 24% 60 or
More informationSpring 2016 INSIDE: Community Health Group s. 34th Anniversary. Message from the CEO
INSIDE: Medicare Stars Team Utilization Management New Member Portal Meals on Wheels Spring 2016 Message from the CEO Community Health Group is fast approaching our 34th anniversary. Time does fly incredibly
More informationDual Eligible Special Needs Plans For 2015
Dual Eligible Special Needs Plans For 2015 Introduction: Amerigroup Community Care is offering Dual Eligible Special Needs Plans (D-SNPs) to people who are eligible for both Medicare and Medicaid benefits
More informationPriorityMedicare Value SM (HMO-POS) Member handbook An overview of your benefits
PriorityMedicare Value SM (HMO-POS) Member handbook An overview of your benefits Y0056_1000_1075_3 CMS-approved 09112014 Table of contents We re here for you...5 Using your dental benefits...19 Quick start
More informationGenerations Advantage Focus DC (HMO SNP) Diabetes Care Special Needs Plan GENERAL MODEL OF CARE (MOC) TRAINING
Generations Advantage Focus DC (HMO SNP) Diabetes Care Special Needs Plan GENERAL MODEL OF CARE (MOC) TRAINING Through this training you will learn: What is a SNP? What is Martin s Point Generations Advantage
More informationThe Right Idea. Save money while you help your health. Meet your advocates A case for generics Easy ways to lower your spending
The Right Idea Save money while you help your health Meet your advocates A case for generics Easy ways to lower your spending one TO one NEWSLETTER FOR MEDICARE ADVANTAGE MEMBERS A SUNNY AFTERNOON NEAR
More informationProviderNews2013 Quarter 2
NEW JERSEY ProviderNews2013 Quarter 2 More Than a Score: Working Together to Achieve Better Health Outcomes While Meeting HEDIS Measures Our Quality Improvement Program When it comes to quality, we re
More informationMEMBER. Communicating With Your Doctors for Better Coordination of Care FOCUS GEORGIA 2016 ISSUE III
GEORGIA 2016 ISSUE III MEMBER FOCUS Communicating With Your Doctors for Better Coordination of Care Sooner or later everyone sees more than one doctor. All of your doctors should have the information they
More informationspecial needs plan (hmo snp) MEDICARE advantage plan summary of benefits Serving Members in Douglas & Klamath Counties
special needs plan (hmo snp) 2017 MEDICARE advantage plan summary of benefits Serving Members in Douglas & Klamath Counties Table of Contents About the Summary of Benefits... 2 Who Can Join?... 2 Which
More informationAGEWELL NEW YORK S DEPRESSION MANAGEMENT PROGRAM
High quality and affordable health care coverage for your patients and our members 866-586-8044 800-662-1220 (TTY/TDD) agewellnewyork.com AGEWELL NEW YORK S DEPRESSION MANAGEMENT PROGRAM AgeWell New York
More informationPersonal Health Care Journal
Personal Health Care Journal U.S. Administration on Aging Take an active role in your own health care! Protect Detect Report Protect Your Personal Information Treat your Medicare, Medicaid and Social Security
More informationYour Guide to keeping your Kaiser Permanente Medicare health plan
Your Guide to keeping your Kaiser Permanente Medicare health plan KP Library: 42-35102677_Corbis_RF_LG_CMYK.psd Your Kaiser Permanente group Medicare health plan is changing and we re still here for you.
More informationCaring for Hawai i Caring for Family: A Message from Monette Bringas
HAWAI I 2015 ISSUE III Caring for Hawai i Caring for Family: A Message from Monette Bringas Aloha! Living with a chronic condition can be a challenge. But you don t have to face it alone. If you re ready
More informationA Publication for Molina Healthcare Members Spring 2005
Molina Healthcare Health & Family In This Issue Page We Want to Give Good Care...2 Preventive Health Testing...3 Cancer... The Good News...3 Why see a Doctor when well?...4 Rights and Responsibilites...5
More informationGateway to Practitioner Excellence GPE 2017 Medicaid & Medicare
Gateway to Practitioner Excellence GPE 2017 Medicaid & Medicare Recognizing and Rewarding Excellent Practices Improving the Health of Gateway Members PRACTICE ELIGIBILITY (see PCMH slide #27 for separate
More informationmember news In this issue: FirstCare STAR & CHIP November 2016 FirstCare Extra Benefits pg 4 Getting Answers to Your Questions pg 6
member news November 2016 FirstCare STAR & CHIP In this issue: Quality Improvement (QI) Program pg 2 Services Needing Approval pg 3 Case Management Services pg 3 Interpretation Services pg 3 FirstCare
More informationPROVIDER NEWSLETTER. Illinois 2016 Issue II DISEASE MANAGEMENT IMPROVING MEMBERS HEALTH IN THIS ISSUE
Illinois 2016 Issue II PROVIDER NEWSLETTER DISEASE MANAGEMENT IMPROVING MEMBERS HEALTH Disease Management is a no-cost, voluntary program to assist members with specific chronic conditions. A member is
More information2018 Medication Therapy Management Program Information
2018 Medication Therapy Management Program Information What is the Medication Therapy Management Program? The Medication Therapy Management Program is a service for members with multiple health conditions
More informationPATH Program. Getting Started Guide
PATH Program Getting Started Guide We have a BIG opportunity. Together, we can empower and encourage people to take an active role in their health. Preventive health care services help people find and
More information3 Ways to Increase Patient Visits
3 Ways to Increase Patient Visits 3 Ways to Increase Patient Visits www.kareo.com kareo.com Table of Contents Introduction 03 Create an Effective Recall/Recare Program 04 Build and Manage Your Online Presence
More informationSPECIAL NEEDS PLAN. Model of Care Training
SPECIAL NEEDS PLAN Model of Care Training WHAT IS A SNP? The Medicare Modernization Act of 2003 established Special Needs Plans (SNP). Centers Plan for Healthy Living (CPHL) participates in two types of
More informationProviderNews2015. a growing issue TEXAS. Body mass index and obesity: Tips and tools for tackling
TEXAS ProviderNews2015 Quarter 2 Body mass index and obesity: Tips and tools for tackling a growing issue For adults, overweight and obesity ranges are determined by using weight and height to calculate
More informationPassport Advantage (HMO SNP) Model of Care Training (Providers)
Passport Advantage (HMO SNP) Model of Care Training (Providers) 2018 Passport Advantage (HMO SNP) is an HMO Special Needs plan with a Medicare contract and an agreement with the Kentucky Department for
More informationMedicare Plus Blue SM Group PPO. Resource Guide. Put your coverage to work. Michigan Public School Employees Retirement System
2018 Medicare Plus Blue SM Group PPO Resource Guide Put your coverage to work Michigan Public School Employees Retirement System www.bcbsm.com/mpsers Make your coverage work for you We want you to know
More informationNutrition and Adult. Day Health Programs IT S MORE THAN A MEAL. Table of Contents. Nutrition and Adult Day Care Programs
IT S MORE THAN A MEAL Nutrition and Adult Table of Contents Nutrition and Adult Day Care Programs 9........ Introduction 10....... The Role of your Program in Promoting Health 11....... Facts About the
More informationAnthem Blue Cross Cal MediConnect Plan (Medicare- Medicaid Plan) Santa Clara County Behavioral Health provider training
Anthem Blue Cross Cal MediConnect Plan (Medicare- Medicaid Plan) Santa Clara County Behavioral Health provider training Anthem Blue Cross Cal MediConnect Plan Effective January 1, 2015, Anthem Blue Cross
More informationProvider newsletter. Dental Home Program launches for member s age 0 6
Provider newsletter Dental Home Program launches for member s age 0 6 Aetna Better Health of New Jersey is pleased to inform you of our new Primary Care Dental Home Program for member s ages 0 6 has launched.
More informationImportant RMHP Pharmacy Change for 2016
Fall 2015 Provider Edition Important RMHP Pharmacy Change for 2016 In an effort to control increasing medication costs, RMHP will begin using MedImpact s High Performance pharmacy network beginning January
More informationHEDIS TOOLKIT FOR PROVIDER OFFICES. A Guide to Understanding Medicaid Measure Compliance
HEDIS TOOLKIT FOR PROVIDER OFFICES A Guide to Understanding Medicaid Measure Compliance TABLE OF CONTENTS WHAT IS HEDIS 1?... 1 ANNUAL HEDIS TIMELINE... 2 HEDIS MEDICAL RECORD REQUEST PROCESS:... 2 TIPS
More informationSummary of Benefits. January 1, 2018 December 31, Providence Medicare Dual Plus (HMO SNP)
Summary of Benefits January 1, 2018 December 31, 2018 Providence Medicare Dual Plus (HMO SNP) This plan is available in Clackamas, Multnomah and Washington counties in Oregon for members who are eligible
More informationAssistance. Improving. Consumer Health. Strategies for
Assistance Strategies for Improving Consumer Health A resource to help educate consumers about available preventive health incentives and eliminating barriers to receiving care www.bhpi.org www.healthsharesolutions.org
More informationSchool Nutrition Programs
School Nutrition Programs School nutrition programs have a long history of meeting the food and nutrition needs of children. Children need to be well nourished and school meals help meet this goal. School
More informationPASSPORT TO GOOD HEALTH
PASSPORT TO GOOD HEALTH H6864_GN519_Rewards Program PASSPORT TO GOOD HEALTH GuildNet is offering the rewards program for members enrolled in the GuildNet Gold plan again in 2017! Your health is important
More informationALL NEW ALOHACARE WEBSITE
NEWS FOR PHYSICIANS AND PROVIDERS QUARTER 4 2017 NEW STREAMLINED PRIOR AUTHORIZATION PROCESS AlohaCare will implement a simplified and reduced list of services requiring Prior Authorization effective January
More informationCONNECTIONS A. Promoting continuity of care during behavioral health treatment. Year-End Provider Incentive Program to Improve Member Health Outcomes
CONNECTIONS A Transition to Optum : Promoting continuity of care during behavioral health treatment Beginning January 1, 2018, we will offer behavioral health services to health plan members through Optum.
More informationCaring for you. Looking after yourself when you are a carer
Caring for you Looking after yourself when you are a carer Most carers would agree caring can be hard work, both mentally and physically. Sometimes everything seems to focus on the person you are caring
More informationWELLNESS POLICY. The Village for Families & Children Revised 11/10/2016 Page 1 of 7
WELLNESS POLICY Comments/feedback welcomed as part of the annual review/revision process. Please see section VI below that addresses the most recent evaluation and progress made in attaining the goals
More informationShana Scott, JD, MPH, Health Systems Team Lead Tuesday, October 3, 2017
Health Systems Transformation & Health System Interventions: Innovative Public Health Approaches to Improve Quality of Care for Georgians with Chronic Conditions Presentation at 2017 Southern Obesity Summit
More informationMedicare & Medicare Supplemental Insurance (Medigap)
Elder Law Basics Medicare & Medicare Supplemental Insurance (Medigap) Steven A. Kass, Esq., CELA Law Office of Steven A. Kass, PC 105 Maxess Road, Suite N116 Melville, New York 11747 What is Medicare?
More informationPROGRAM OVERVIEW FOR SALARIED EMPLOYEES. Take an Active Role in Managing Your Health
PROGRAM OVERVIEW FOR SALARIED EMPLOYEES Take an Active Role in Managing Your Health Boise Cascade wants you to lead a healthy, happy life. That starts with your lifestyle choices and s Healthy Measures
More informationClear and Easy. Skypark Publishing. Molina Healthcare 24 Hour Nurse Advice Line
Clear and Easy #6 Molina Healthcare 24 Hour Nurse Advice Line 1-888-275-8750 TTY: 1-866-735-2929 Molina Healthcare Línea de TeleSalud Disponible las 24 Horas 1-866-648-3537 TTY: 1-866-833-4703 Skypark
More informationMCS Model of Care For Special Needs Plans (SNP) Annual training for delegated entities and facilities
2018 MCS Model of Care For Special Needs Plans (SNP) Annual training for delegated entities and facilities Quality Department CAN_2790318S CMS Requirements The Centers of Medicare & Medicaid Services (CMS)
More informationAETNA BETTER HEALTH OF VIRGINIA Provider Newsletter
AETNA BETTER HEALTH OF VIRGINIA Provider Newsletter Winter 2016 Table of Contents 2017 HEDIS Tips...1 Member Rights and Responsibilities..2 Interpreter and Translation Services..2 Practice Guidelines...3
More informationHEDIS 101 for Providers 2018
HEDIS 101 for Providers 2018 Improving Quality of Care HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA). Author: Commercial & GBD Communication HEDIS Team Document
More informationQuality Improvement Program
How we measure up At HealthKeepers, Inc., we focus on helping our Anthem HealthKeepers Plus members get healthy and stay healthy. To help us serve you the best we can, each year we look closely at the
More informationSummary Of Benefits. WASHINGTON Pierce and Snohomish
Summary Of Benefits WASHINGTON Pierce and Snohomish 2018 Molina Medicare Choice (HMO SNP) (800) 665-1029, TTY/TDD 711 7 days a week, 8 a.m. 8 p.m. local time H5823_18_1099_0007_WAChoSB Accepted 9/26/2017
More informationCONNECT. Member. In This. Winter HMO Medicare Member Newsletter
In This Winter 2017 Member CONNECT HMO Medicare Member Newsletter 2 Medication Therapy Management (MTM) 2 Here s to Your Health! 3 Be Prepared For Your Doctors Visit 3 Always Available to Our Members 4
More informationWorksite Wellness Drs. Sal, Sebastian & Singh
Worksite Wellness Drs. Sal, Sebastian & Singh Dr. Carmella Sebastian, Dr. Carm, received her MD degree from the Medical College of Pennsylvania. She earned her Master s Degree in Healthcare Administration
More informationSummary of Benefits. New York: Bronx, Kings, New York, Queens and Richmond Counties
Summary of Benefits New York: Bronx, Kings, New York, Queens and Richmond Counties January 1, 2006 - December 31, 2006 You ve earned the right to live life on your own terms. And that includes the right
More informationA Guide to Accessing Quality Health Care
A Guide to Accessing Quality Health Care Spring 2015 MolinaHealthcare.com 37894DM0115 Molina Healthcare s Quality Improvement Plan and Program Your health care is important to us. We want to hear how we
More informationProviderNews2013. Recent and upcoming changes to our precertification, utilization management and clinical practice guidelines NEW JERSEY
NEW JERSEY ProviderNews2013 Recent and upcoming changes to our precertification, utilization management and clinical practice guidelines We already faxed or mailed and posted notices on our website about
More informationNEWSLETTER PROVIDER. Tufts Health Plan Senior Care Options Tufts Medicare Preferred HMO. Update Your Practice Information
PROVIDER Tufts Health Plan Senior Care Options Tufts Medicare Preferred HMO NEWSLETTER DECEMBER 2016 Update Your Practice Information Providers are reminded to notify Tufts Health Plan of any changes to
More informationHEDIS Measures and the Family Physician Office. Pablo J Calzada DO, MPH, FAAFP, FACOFP
HEDIS Measures and the Family Physician Office Pablo J Calzada DO, MPH, FAAFP, FACOFP Disclaimer HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA). NCQA and payers
More informationMEDICARE CARE1ST DUAL PLUS PLAN SUMMARY OF BENEFITS.
ine 1-800-544-0088 www.care1st.com CARE1ST DUAL PLUS PLAN SUMMARY OF BENEFITS MEDICARE 2009 COUNTIES: LOS ANGELES - ORANGE - SAN BERNARDINO - SAN DIEGO H5928_09_004_SNP_SB 10/2008 Section I Introduction
More informationProviderNews2014 Quarter 3
TEXAS ProviderNews2014 Quarter 3 Our Quality Improvement program The Amerigroup* Quality Improvement (QI) program is committed to excellence in the quality of service and care our members receive and the
More informationNote: Accredited is the highest rating an exchange product can have for 2015.
Quality Overview Accreditation Exchange Product Accrediting Organization: NCQA HMO (Exchange) Accreditation Status: Accredited Note: Accredited is the highest rating an exchange product can have for 215.
More informationInside this Issue: CAHPS Member Survey Results Exceeded NCQA National Averages. Taxonomy Update!
Third Quarter 2013 Inside this Issue: Shared Decision Making 2 BMI Percentile 2 Case Management 2 Tobacco Cessation Program 3 Practice Guidelines 3 HEDIS Spotlight 3 Flu Season 4 RSV Season 4 Lock-In Program
More informationPatient Protection and Affordable Care Act Selected Prevention Provisions 11/19
Patient Protection and Affordable Care Act Selected Prevention Provisions 11/19 Coverage of Preventive Health Services (Sec. 2708) Stipulates that a group health plan and a health insurance issuer offering
More informationTable of Contents. ii 2016 New Jersey HMO & PPO Performance Report
Table of Contents Commissioner s Letter... 1 Introduction... 2 Quality Matters... 3 Staying Healthy... 4 Breast Cancer Screening... 5 Cervical Cancer Screening... 6 Colorectal Cancer Screening... 7 Childhood
More informationAdvocare. Connection. Advocare plans are here to stay. Preventing three silent threats
Advocare Connection Preventing three silent threats Page 4 Advocare plans are here to stay Page 3 Nonprofit Organization U.S. Postage Paid Security Health Plan of Wisconsin, INC. Security Health Plan of
More informationSpecial Needs Plans (SNP) Model of Care (MOC) Initial and Annual Training
Special Needs Plans (SNP) Model of Care (MOC) Initial and Annual Training 2018 Learning Objectives Program participants will be able to: List the three overall goals of the SNP Model of Care Describe the
More informationMedicare: 2017 Model of Care Training 4/13/2017
Medicare: 2017 Model of Care Training Training Objectives This course will describe how MHS Health Wisconsin Medicare Advantage and its contracted providers work together to successfully deliver the Model
More informationPARAMEDIC REFRESHER COURSE
Essential Medical Training, LLC Providing Quality, Professional Training PARAMEDIC REFRESHER COURSE 48 hours of Continuing Education This course is approved by the Florida Bureau of EMS for continuing
More informationSummary Of Benefits. IDAHO Ada, Bannock, Bingham, Bonner, Bonneville, Canyon, Kootenai, Nez Perce, and Twin Falls
Summary Of Benefits IDAHO Ada, Bannock, Bingham, Bonner, Bonneville, Canyon, Kootenai, Nez Perce, and Twin Falls 2018 Molina Medicare Options Plus (HMO SNP) (844) 239-4913, TTY/TDD 711 7 days a week, 8
More information