Skip to main content
Arizona Care Network

A Better State of Care

Set location

← All resources
Newsletter

ACN Advance - December 2024

From Us to You: Happy Holidays and 'Thank You'

Upcoming Gainshare Distributions and 2025 PRP Updates

Physician Board of Managers Ready for 2025

2025 ACN Payer Partners

Quality: Benefits of Utilizing ACN's Remote EMR Access

Pharmacy: Important Changes to Medicare Part D Coverage

Pharmacy: 2024 Stroke Prevention Guidelines

News Roundup

Welcome, New Provider Organizations

Happy Holidays and 'Thank You'

As another year winds down, all of us at Arizona Care Network give thanks for the care you have given to your patients, and for your collaboration with our team and your fellow providers in the network. Supporting your practice and ensuring your patients’ access to screenings, primary care, and specialty care services they need through the following program and initiatives is the most important and fulfilling work we do, including:

    • Gainshare opportunities that reward practices for in-network, high-quality, cost-efficient patient care within the Medicare Shared Savings Program (MSSP) and ACN’s value-based arrangements (more information within this newsletter and from your practice’s dedicated Clinical Performance Consultant),
    • Provider Rewards Program (PRP) improvements for primary care practices in 2025 (more information coming soon from your dedicated CPC),
    • Innovaccer and OneNote technology platforms that improve care coordination efforts, support care gap closures, and promote important, patient-focused data sharing between primary care and specialist providers,
    • Coordinated patient outreach via text message and auto-dialer platforms to provide patients with targeted, actionable reminders and available support at their fingertips for appointment scheduling, care coordination assistance, and more.
    • Care Coordination support delivered to patients by a team of dedicated health care professionals ready to support your patients’ care plans and assist patients with complex needs and potential SDOH barriers.

You may always contact your CPC or email practicetransformation@azcarenetwork.org to provide your practice with information and education that supports your success. On behalf of your physician-led Board of Managers and Executive Leadership Team, we wish you a happy, healthy, and joyful holiday season. Thank you for participating with ACN! Todd Ricotta CEO

Image

Since 2015, Arizona Care Network has been fortunate to recognize and reward eligible primary care practices for the high quality, cost-efficient and coordinated care they provide their patients via the incentives we distribute each quarter through our Provider Rewards Program (PRP). ACN is also thrilled when the network earns additional incentives under our various payer contracts that can be shared with participating primary care practices, as was the case for our value-based agreements with CMS (Medicare Shared Savings Program), and Mercy Care for the 2023 performance year. In recognition of the network’s performance in caring for attributed Medicare and Mercy Care patients, ACN will issue gainshare payments to eligible primary care practices in December. At that time, eligible practices will also receive additional details and supporting information related to this year’s annual gainshare distribution from their Clinical Performance Consultant (CPC). Congratulations to all eligible primary care practices! These gainshare incentives are a testament to your dedication, hard work, and proactive approach in delivering and arranging for the care your patients need from the specialists, facility and other ancillary providers that participate with ACN. In addition, the Board of Managers approved an improved 2025 Provider Rewards Program in December. Eligible primary care practices will receive education materials for the PRP during Q1 2025 from their dedicated CPC. Please contact your Clinical Performance Consultant or email practicetransformation@azcarenetwork.org with any questions or feedback about any of these gainshare opportunities for your practice.

Arizona Care Network’s Board of Managers completed several governance action items for 2025 during its December meeting. Dr. Deepanshu Garg (Med-Cure Internal Medicine) will serve as Board Chair for a 2-year term. Dr. Garg previously served as Vice Chair and is also a member of the Network Committee. Dr. Garg replaces Dr. Kevin Theodorou (Internal Medicine of the Valley), whose term as Chair concludes at the end of 2024. Dr. Theodorou will continue serving on the Board in 2025, and ACN is grateful for his long-standing contributions and commitment to the organization. In addition to Dr. Theodorou, two current Board members and two new physicians, respectively (below), were elected to terms beginning in 2025:

    • Dr. Drew Hall (Hall Medical)
    • Dr. Pankaj Jain (Arizona Urology)
    • Dr. Sunny Jhamnani (Tri-City Cardiology)
    • Dr. Megan Jhaver (Infinity Internal Medicine)

ACN also wishes to thank outgoing Board members for their continued participation and numerous contributions:

    • Dr. Sunita Gupta (East Valley Family Practice)
    • Dr. Christopher Pruitt (Sound Physicians)
    • Dr. Srivani Srikantiah (Srivani Srikantiah MD PLLC)
    • Dr. Monte Swarup (Women’s Health Arizona)

Physicians interested in learning more about becoming a Board of Managers' member, or one of ACN’s three governance committees – the Network Committee, the Post-Acute Care Committee, or the Quality & Payer Contracting Committee – can email governance@azcarenetwork.org for additional information.

A quick reminder: After three years in Arizona, Medica is departing the Arizona market as of Dec. 31, 2024. Earlier this summer, Medica members received this letter informing them of Medica’s decision. ACN served as Medica’s exclusive network for Pinnacle, the individual and family plan (IFP) it offers on the ACA Exchange. ACN is currently in negotiations with a new payer that will offer plans on the Exchange. Watch for further Bulletin and Newsletter communications in 2025. Here is a quick overview of ACN’s active Payer partners in 2025:

    • Aetna (PPO, HMO, Medicare Advantage)
    • Alignment Health Plan (Medicare Advantage PPO/HMO)
    • Blue Cross Blue Shield of Texas (Abrazo Health employees and dependents)
    • Cigna (Open Access Plan, LocalPlus)
    • Employers Health Network (EHN) (Whole Foods Market employees)
    • Humana (Medicare Advantage)
    • Intel employees (Connected Care HDHP/PPO/PCP)
    • Medicare Shared Savings Program (MSSP) (Medicare Fee-For-Service)
    • Mercy Care (Medicaid, Medicare Advantage)
    • UMR (Dignity Health employees Preferred/Premier)
    • UnitedHealthcare (Choice Plus PPO Navigate/Nexus ACO, Community & State)

Members within these plans who visit an ACN-participating provider(s) may be automatically eligible for Care Coordination and other in-network support services as part of their coverage benefits. A quick reference guide featuring ACN partners’ member ID card samples and claims information will be available from your Clinical Performance Consultant during Q1 2025. Please contact your CPC or email practicetransformation@azcarenetwork.org to receive copies of this .PDF document.

Quality Corner: Benefits of Utilizing ACN's Remote EMR Access

To further ease your practice’s staffing and administrative burdens, Arizona Care Network can support your patient care through secure, remote EMR access. There are multiple valuable benefits to granting ACN access to your EMR system:

Quality Gap Closure

Remote EMR access allows for faster, more efficient data abstraction. This reduces the administrative workload of your practice in responding to medical record request faxes from ACN and abstracting the medical records. In addition, ACN can turn around payor requests during short quality reconciliation time frames. ACN can review more medical records with remote EMR access, and, overall, have a higher chance of achieving quality targets for shared savings for your provider network.

Additional Resources

In addition, Quality measure tip sheets are available for you to print, or from your Clinical Performance Consultant. These 1-page tip sheets (.PDF) include best practices, documentation requirements, and codes for your practice to help close quality gaps:

      • Blood pressure
      • Breast cancer screening
      • Cervical cancer screening
      • Chlamydia screening
      • Colorectal cancer screening
      • Depression screening and follow-up
      • Diabetes (A1C, Eye Exam, Nephropathy)
      • Immunizations
      • Medication adherence
      • Opioid usage
      • Osteoporosis
      • Social Determinants of Health (SDOH)
      • Tobacco screening, and more

Please contact your CPC or email practicetransformation@azcarenetwork.org to begin remote EMR access and/or to receive any tip sheets.

Pharmacy Corner: Important Changes to Medicare Part D Coverage

Tannaz Farahani, MPH, PharmD Manager, Population Health Pharmacy Arizona Care Network The Inflation Reduction Act of 2022 included several important updates to out-of-pocket prescription medication costs, and specifically for Medicare Part D members. Significant Part D changes scheduled to take effect on Jan. 1, 2025, include:

    • The total maximum out-of-pocket (OOP) cost Part D members will pay for covered medications is $2,000, which includes his/her yearly deductible.
    • Part D enrollers will have the option to spread their OOP costs during the calendar year (referred to as “OOP smoothing”) by enrolling in the Medicare Prescription Payment Plan Program. This option is available within both standalone Medicare prescription drug plans and Medicare Advantage plans with prescription drug coverage.
    • The Extra Helpprogram for low-income or low-resource members who are enrolled in a Medicare prescription plan has expanded. Qualifications and application information are available here.
    • The temporary 100% payment coverage gap phase (sometimes referred to as “the donut hole”) is eliminated.

Resources

Have medication-related questions or would like additional patient support? Contact Tannaz at tannaz.farahani@azcarenetwork.org.

Pharmacy Corner: 2024 Stroke Prevention Guidelines

Tannaz Farahani, MPH, PharmD Manager, Population Health Pharmacy Arizona Care Network The American Heart Association/American Stroke Association recently released its 2024 guidelines for stroke prevention. The ASA also estimates that 80 percent of strokes could be prevented. The guidelines highlight 10 of the most significant factors toward stroke prevention:

    • From birth to old age: regular visits with a primary care health professional to identify and achieve opportunities to promote brain health.
    • Importance of Social Determinants of Health (SDOH)
      • non-medical factors
      • Patient-level SDOH includes health care access, health literacy, food security, and housing security.
    • Patient education provided at the appropriate educational levels and language.
    • Diet
      • The Mediterranean Diet has shown to reduce the risk of stroke,
      • Supplemented with nuts and olive oil
      • Low-fat diets have had little impact on reducing the risk. Adults with no prior cardiovascular disease and those with high or intermediate risk adhere to the Mediterranean diet.
    • Physical activity
      • It is essential for cardiovascular health and stroke risk reduction.
      • Prolonged sedentary behavior during waking hours is associated with an increased risk of stroke.
      • This is in addition to the recommendation to engage in regular moderate to vigorous physical activity.
    • Glucagon-like protein-1 receptor agonists (GLP-1)
      • Effective for improving management of Type 2 Diabetes, weight loss, and lowered risk of cardiovascular disease and stroke.
    • Blood pressure management is critical for stroke prevention.
      • Randomized controlled trials have demonstrated that treatment with one antihypertensive medication is effective for reaching the blood pressure goal in only approx. 30 percent of participants and that most participants achieved the goal with 2 or 3 medications.
      • Therefore, ≥2 antihypertensive medications are recommended for primary stroke prevention in most patients who require pharmacological treatment of hypertension.
    • Antiplatelet therapy
      • recommended for patients with antiphospholipid syndrome or systemic lupus erythematosus without a history of stroke or unprovoked venous thromboembolism to prevent stroke.
      • Patients with antiphospholipid syndrome who have had a prior unprovoked venous thrombosis benefit from Vitamin K antagonist therapy over direct oral anticoagulants.
    • Women’s Health
      • Adverse pregnancy outcomes are common and are associated with chronic hypertension and an elevated stroke risk later in life.
      • Prevention of pregnancy-related stroke is achieved primarily through management of hypertension.
        • Treatment of verified systolic blood pressure ≥160 mm Hg or diastolic blood pressure ≥110 mm Hg during pregnancy and within 6 weeks postpartum is recommended to reduce the risk of fatal maternal intracerebral hemorrhage.
        • Endometriosis, premature ovarian failure (before 40 years of age), and early-onset menopause(before 45 years of age) are all associated with an increased risk for stroke.
      • Screening for all three of these conditions is a reasonable step in the evaluation and management of vascular risk factors in these individuals to reduce stroke risk.
    • Transgender Health
      • Transgender women taking estrogens for gender affirmation have been identified as having an increased risk of stroke.
      • Evaluation and modification of risk factors could be beneficial for stroke risk reduction in this population.

Network News Roundup

  • Follow us on Facebook, Twitter,LinkedIn, and YouTube for additional news, health-related content for providers and patients, organizational updates, and more.
  • Learn more about ACN’s Care Coordinationprogram and services designed to partner and support your practice in achieving healthy, cost-effective patient outcomes in thisvideo.
  • ACN’s improved Specialist Performance Reportsand Medical Neighborhood Maps are available to your practice anytime. Additionally, Behavioral Health, OB/GYN, Ophthalmology/Optometry, Physical Therapy, and Radiology listings 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.
  • 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.orgto receive any/all tip sheets.
  • A Payer ID Card Quick Reference (.PDF) document for 2025 will be available from your Clinical Performance Consultant during Q1 of 2025. This document contains samples of ID Cards from ACN payer partners, as well as contact information. Contact your CPC or email practicetransformation@azcarenetwork.orgif your practice would like copies of this document.
  • Dignity Health is offering a Continuing Medical Education (CME) course on Advancements in Robotic Assisted Joint Replacement Surgery on Thursday, Feb. 20, from 5:30-7:30 p.m. at TopGolf in Gilbert. Dinner, cocktails, and golf are included. More information and registration information are available here.
  • Up to 5.5 hours of CME credits are available through the American College of Lifestyle’s Lifestyle as Medicine and Food as Medicine online classes. The three classes explore food and nutrition in relation to prevention, treatment, and reduction of chronic diseases. The course is available for free online through Sept. 14, 2025. More information and registration are available here.
  • Abrazo West Campus recently debuted “Da Vinci 5,” an AI surgical robot that offers more than 150 enhancements, including new surgeon controllers, powerful vibration, and tremor controls for even smoother and more precise movements. “Da Vinci 5” is equipped with a high-quality and natural 3D imaging system and has already been used by surgeons treating patients requiring colorectal surgery, hernia repair, appendectomy, gall bladder removal, and more.
  • Abrazo Scottsdale Campus was recently named a bariatric surgery Center of Excellence by OptumHealth Care Solutions. Hospitals earn this prestigious designation by meeting certain measures of clinical quality, cost efficiency, and access to comprehensive bariatric (weight loss) services. More information about the program is available here.
  • For the 14th consecutive year, U.S. News & World Report ranked Phoenix Children’s among the nation’s “Best Children’s Hospitals.” The health system was again named the No. 1 children’s hospital in Arizona and third in the Southwest region. Phoenix Children’s is the only children’s hospital in Arizona ever to be recognized by U.S. News & World Report.
  • Cigna has a collection of Behavioral Health resources supporting both children and adolescent patient populations, and additional provider resources in working with Cigna members.

Welcome, New Provider Organizations!

      • Advanced Pain Modalities
      • ASDA Internal Medicine
      • Bonhoeffer Rheumatology Institute
      • Geriatric Specialists of Arizona
      • Gobran Shahla, MD
      • Healthy You AZ
      • Sanitas Medical Group
      • Valley Bariatric

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