ACN Advance: Provider Newsletter

Arizona Care Network is proud to host a second Community Health Fair on Saturday, May 18, at MY DR NOW in Phoenix.

In partnership with MY DR NOW, Arizona Diagnostic Radiology Group (AZDRG), and BreastLink, a mobile mammogram will be on-site for ACN members from 7 a.m. to 4 p.m. Most mammograms are a $0 co-pay, but members should verify with insurance in advance.

Additionally, no-cost blood pressure checks, and a variety of health care professionals will be on-hand to share patient resources and answer questions from 11 a.m. to 1 p.m.

Mobile Mammogram RSVP

Advanced scheduling for a mammogram is strongly recommended, as walk-in appointments will be very limited. Members may need some insurance card information to complete the scheduling process.

Members may schedule their mammogram by either:

• • • Calling ACN at (602) 406-7226 during normal business hours.
    • Emailing members@azcarenetwork.org and including:
      • • Member Name
        • Email address and/or phone number
        • Insurance provider

We look forward to seeing everyone on May 18!

As Arizona Care Network continually seeks to improve coordination of care for patients and reduce the average cost-of-care for inpatient and outpatient services to meet the value-based care objectives of our payer partners, the physician-led Board of Managers approved updated participation requirements for specialists, effective Jan. 1, 2024.

These updated guidelines build upon the specialist participation requirements adopted in 2023 to help ensure care is more affordable for patients accessing the network, and entail the following:

• • • Effective Jan. 1, 2024: Physicians who treat patients at in-network facilities less than 33 percent of the time (with a minimum of 5 direct admissions at inpatient and outpatient facilities on a 12-month rolling basis) will no longer be eligible to participate with ACN.
    • Effective Jan. 1, 2025: Physicians who treat patients at in-network facilities less than 50 percent of the time in 2025 (with a minimum of 5 direct admissions at inpatient and outpatient facilities on a 12-month rolling basis) will no longer be eligible to participate with ACN.

Impacted specialties to these new requirements received a notification letter at the TIN level in early March explaining the updated guidelines.

Individual physicians who do not meet these new requirements will be removed from ACN’s provider- and member- facing directories effective the first day of an upcoming quarter. These physicians will also be removed from rosters ACN sends to its payer partners for removal from the network, effective 90 days later (270 days later for OB-GYN providers and 365 days later for Oncology providers) to ensure continuity of care for patients.

If you have any questions about these participation requirements, or wish to receive additional guidance of this new participation requirement for your organization, please contact your dedicated Clinical Performance Consultant or email practicetransformation@azcarenetwork.org.

As part of ACN’s MSSP Enhanced participation requirements, CMS requires beneficiaries attributed to participating primary care practices are notified of his/her primary care provider participates with ACN as part of the MSSP Enhanced program.

The beneficiary notification letter will be mailed to impacted beneficiaries by early April.

A verbal or written follow-up communication (written, email, verbal, telephonic) is required no later than the next visit following the initial beneficiary notification or, if no subsequent visit, within 180 days from the initial beneficiary notification:

• • • This communication gives beneficiaries an opportunity to ask questions about MSSP Enhanced and its benefits.
    • ACN can provide materials to your staff to help answer beneficiary questions and that can be shared with your Medicare beneficiaries at their second visit or pushed through your patient portal (2024 materials are identical to 2023 materials).
    • ACN will send a subsequent notification to beneficiaries in late Spring or early Summer that have not had a subsequent visit within the 180-day timeframe.

Please contact your Clinical Performance Consultant or email practicetransformation@azcarenetwork.org with any questions or feedback.

Each year, ACN must report on the CMS Quality Measures for practices that participate in the Medicare Shared Savings Plan (MSSP) Enhanced program.

We report these measures to CMS through an audit called the Group Practice Reporting Option (GPRO). The audit runs from January through March.

For clinicians who participated in a Medicare ACO in 2023, the GPRO audit fulfills your MIPS Quality Reporting requirement. The audit also impacts ACN’s gainshare opportunity for the 2023 reporting year. We take the audit very seriously and commit extensive ACN resources to ensure successful reporting.

ACN makes every effort to abstract data with minimal disruption to your office staff. Here are a few things to consider as we conclude the auditing process and look ahead to the 2024 reporting year.

• • • All EMRs have audit roles available for provisioning. If you have any questions, please contact provisioning@azcarenetwork.org.
    • A designated point of contact within your practice or organization to work with minimizes office staff disruption. If you haven’t already done so, please help us identify the best point of contact for your ACN Data Abstractor moving forward by sending us your POC name and email address to quality@azcarenetwork.org.

As always, ACN greatly appreciates your cooperation and support. If you have any questions about the GPRO audit, please contact your Clinical Performance Consultant or email practicetransformation@azcarenetwork.org.

The provisioning process has begun for ACN’s new self-service performance dashboard for primary care practices.

Transitioning to Innovaccer’s multi-dashboard program allows your practice easy access to actionable and downloadable data, metrics, and network utilization insights that further promote efficient, cost-effective patient care within the network.

Available dashboards for your practice that were previously unavailable include:

• • • Attribution: Provides a detailed Patient Attribution List with drill-down capabilities and new data download options.
    • Quality: Uses artificial intelligence (AI) to provide detailed analyses of your practice’s quality performance, insights, and recommended actions for improvement. The dashboard breaks down quality scores and performance by payer partner, practice, or provider.
    • PCP Scorecard: Benchmarks your performance against others in the network using key metrics, including patient panel size, quality, and financial indicators. Access a thorough demographic and health risk analysis of your patient population, alongside an evaluation of care quality and cost management. The available critical assessment of your practice’s risk documentation is easily comparable to overall risk recapture rates.

Additional dashboards for PCP and Specialist practices will be available during the coming year.

Please contact your Clinical Performance Consultant or email practicetransformation@azcarenetwork.org to begin the Provisioning process for your TIN, or with any questions or feedback.

Quality measure tip sheets, medication adherence best practices, and Virtual Health Education videos are now available on ACN’s YouTube page.

These short videos (most are 5 minutes or less) support Quality measures and coding 1-page quick-reference documents available to your practice.

As part of our Virtual Health Education, ACN’s population health pharmacist, Tannaz Farahani, PharmD, MPH, conducts a Q&A with ACN participating providers to discuss a wide range of topics related to each provider’s overall area of expertise:

• • • Quality measures
    • common health conditions and trends
    • treatment options
    • medications
    • adherence, and much more.

Have a pharmacy or medication question? Or topic idea(s) for a future video? Email Tannaz at tannaz.farahani@azcarenetwork.org.

• Follow us on Facebook, Twitter, and LinkedIn for additional news, health-related content for providers and patients, organizational updates, and more.
• Learn more about ACN’s Care Coordination program and services designed to partner and support your practice in achieving healthy, cost-effective patient outcomes in this video.
• ACN’s improved Specialist Performance Reports and Medical Neighborhood Maps are available to your practice anytime. Additionally, OBGYN, Ophthalmology/Optometry, Physical Therapy and Radiology listings quick reference guides are also available. Contact your Clinical Performance Consultant or email practicetransformation@azcarenetwork.org to receive any of these reports and/or maps, all of which are updated quarterly.
• A 1-page Payer ID Card Quick Reference document will be available from your Clinical Performance Consultant during Q1 of 2024. This document contains samples of ID Cards from ACN payer partners, as well as contact information. Contact your CPC or email practicetransformation@azcarenetwork.org if your practice would like copies of this document.
• Quality measure tip sheets are available from your Clinical Performance Consultant, including colorectal cancer screening, depression screening and follow-up, diabetes (A1C, Eye Exam, Nephropathy), Social Determinants of Health (SDOH), and Tobacco screening. These 1-page tip sheets (.PDF) include best practices, documentation requirements, and codes for your practice to help close quality gaps. Contact your Clinical Performance Consultant or email practicetransformation@azcarenetwork.org to receive any/all tip sheets.
• Dignity Health is hosting the Sixth Annual East Valley Stroke Care Conference on April 12 from 7 a.m.-12:30 p.m. in the Kelly & Barnes Auditorium at Chandler Regional Medical Center. This year’s theme, “Advancing Stroke Care with Mechanical Thrombectomy,” includes a variety of presentations surrounding stroke symptoms, management, and imaging. CME credits are available to all providers, while breakfast and lunch is included. More information and to RSVP by April 5 is available here.
• Alignment Health Plan is hosting an important Medicare Risk Adjustment Clinical Documentation & Coding webinar May 22 at 12:15 p.m. This 45-minute webinar is hosted by Dr. Mona Bambha, MD, and will cover HCC coding and documentation training, common HCC coding documentation tips and best practices, and more. Please contact your Clinical Performance Consultant or email practicetransformation@azcarenetwork.org if you wish to participate in the webinar.
• Construction began earlier this year on the first phase of development for Abrazo Health’s new medical campus at Interstate 10 and Verrado Way in Buckeye. The 27-acre campus will include medical offices, ambulatory services, and an acute care hospital. The first phase is a three-story, 60,000-square-foot medical office building. Tenants are slated to include cardiology, orthopedics, spine, primary care and urology physician practices, physical therapy, and other offices.
• Jason D. Fraser, MD, is Phoenix Children’s new division chief of pediatric surgery. Dr. Fraser will provide strategic direction and administrative leadership for neonatal, pediatric and trauma surgery throughout Phoenix Children’s health system, which will include three hospital campuses and three ambulatory surgery centers by the end of 2024.
• Vlad Kalinichenko, MD, PhD, director of the Research Institute and professor of Child Health at the Phoenix Children’s Hospital’s Research Institute at the University of Arizona College of Medicine received a $3 million grant from the National Institutes of Health (NIH) to develop new treatment methods for lung disease in premature infants. Dr. Kalinichenko’s 20-year research career as principal investigator for NHLBI has centered on improving health outcomes for premature infants with respiratory conditions.

• • • Ace Health and Wellness Center
    • Advanced Cardiovascular Center
    • American Vascular Specialists
    • Desert Orthopedics Center
    • Goodman Dermatology and Mohs Surgery
    • Moore Advanced Orthopedics
    • Mountain View Foot & Ankle
    • Papa Bear Pediatrics (PCCN)
    • Phoenix Foot and Ankle Institute
    • Phoenix Unified Surgeons
    • Pinnacle Vein and Vascular Center
    • Primary Care Walk-in Medical Clinic
    • Sunrise Primary Care Partners
    • Walend Family Medicine

You can also view a list of provider organizations no longer participating with ACN.