The Centers for Medicare & Medicaid Services (CMS) issued a final rule on Nov. 1 that updates the physician fee schedule for calendar year 2023. The rule also includes numerous changes that directly impact the Medicare Shared Savings Program and the Quality Payment Program (QPP).
VHAN’s Care Management team often works with patients in the Diabetes Outreach Program to assist them in overcoming health obstacles that can stand in the way of positive outcomes. This was the case with a recent patient who was unable to complete the program due to difficulty having his labs drawn. VHAN Patient Service Specialist Lisa Fatzinger stepped in to offer direct communication and additional support, eventually helping him to complete the program successfully.
Recently, a VHAN RN Care Navigator was able to connect an overlooked patient to much-needed follow-up care after a joint replacement. The 63-year-old female patient with comorbidities was admitted to a hospital for a planned knee replacement, expecting that she would be referred to a rehab facility at discharge. However, after spending a week in the hospital, she was sent home with no follow-up instructions. She understandably felt confused and disconnected from the system and worried about what would happen next—that’s where VHAN’s RN Care Navigator Cheryl Landis stepped in.
Coinciding with VHAN’s 10th anniversary, the third season of the miniVHAN podcast looks back at the unique vision for VHAN and how the network launched amidst a major transition in health care from fee-for-service to value-based care following the signing of the Affordable Care Act in 2010.
To support patients with diabetes, Vanderbilt Primary Care began offering diabetes classes in 2020. After a short stint of in-person classes, COVID-19 caused the organization to move to a virtual environment, and attendance grew exponentially. The free, one-hour courses are held four times per month on Zoom, and they are available to all Vanderbilt Primary Care patients through a provider or nurse referral. Learn more about how Vanderbilt successfully launched this program—and how other practices could possibly do the same.
As the cost of prescription drugs continues to rise, patients’ refusal or inability to pay for costly medications contributes to an estimated 125,000 deaths every year. VHAN’s Care Navigators often take a closer look at patients’ medications and collaborate with the VHAN Pharmacy team to ensure patients are taking the most effective, affordable medications.
VHAN is pleased to announce that the network achieved 100% performance on all Aetna Commercial quality measures in 2021. VHAN members also scored higher than Aetna’s Q4 national average on several measures, including Breast and Colorectal Cancer Screening and Comprehensive Diabetes Care.
Earlier this year, VHAN staff presented on VHAN’s Community Health Worker (CHW) pilot during Aetna’s quarterly Provider Clinical Transformation Webinar Series. The pilot, launched in 2019, was designed to improve access to care and resources for obstetric patients at Gallatin Women’s OBGYN Center (GWC) in Gallatin, Tennessee, which has a large prenatal patient population with approximately 350 babies born annually. The CHW pilot was designed to help with resource referrals and interventions for patients who need assistance with access to health care, physical and behavioral health support, and social determinants such as homelessness, food insecurity and unemployment. During the Aetna presentation, VHAN shared some initial results of the pilot.
VHAN is excited to announce that the network’s pediatric depression screening rate has dramatically improved. In 2019, VHAN began measuring annual depression screening for children 12 and older. To assist members who were struggling in this area, VHAN licensed clinical social workers met with practices to promote the social work program and the benefits of using the pediatric behavioral health consult line. As a result, by 2021, no VHAN members received a score of zero for depression screening and 46% of practices screened 90% of their VHAN patients for depression.