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ACN Advance - July 2022

Honoring 10 Years of ACN Participation

Patient Outreach Underway via Text Message, Email

Additional Mandatory CMS Letters Being Mailed by July 31

SDOH Poses Major Barrier to Patient Care

News Roundup

Welcome, New Provider Organizations

As Arizona Care Network celebrates our 10th year as a Medicare ACO and value-based care partner with commercial, Medicaid and Medicare Advantage plans locally, we look forward to the next decade supporting your practice and patient care. We recognize there are more Medicare ACO organizations than ever before throughout Arizona. But we believe what has made ACN a thriving leader in the Valley for the past decade, also positions us as a leader among value-based networks for the next decade and beyond:

  • Our governing Board of Managers and committee members are local, practicing physicians; contact governance@azcarenetwork.org if you are interested in becoming involved.
  • Autonomy for your practice to provide patient care as determined solely by you and your patients.
  • No-cost care coordination team of nurses, social workers, health coaches, and navigators ready to support your practice and patients.
  • Quarterly Provider Reward Program (PRP) incentives to recognize and reward primary care providers for proactive and cost-effective patient care, and for coordinating care with fellow ACN specialists.
  • Annual incentive program provides stability and consistency while continually offering your practice additional reward opportunities.
  • A committed, geographically accessible specialist network which emphasizes both in-network referral and care coordination opportunities.
  • Dedicated Clinical Performance Consultant provides your practice with updated, actionable data and resources.

Cheers to the past 10 years, to the next 10 years, and thank you for participating with ACN! Todd RicottaCEO

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Since Arizona Care Network began in 2013, we’ve prided ourselves on innovation and evolution as an ACO. From our earliest days within the Medicare Shared Savings Program (MSSP), through the Next Generation Accountable Care Organization (NGACO), and now the Global and Professional Direct Contracting Model (GPDC), 12 practices have participated in our Medicare ACO from the very beginning:

  • Abrazo Medical Group
  • Advanced Internal Medicine
  • Rodd Aking, MD
  • Arrow Medical
  • ASAP Health Solutions
  • Associated Internists of Ahwatukee
  • AZ Internal Medicine
  • Dignity Health Medical Group
  • MY DR NOW
  • Ocotillo Internal Medicine Associates
  • Donald E Paxton, MD
  • Sun Lakes Family Physicians

We are eternally grateful for your practice and staff as ACN participants, and are especially thankful to the nearly 50 primary care practices that participate in our Medicare ACO. If your primary care practice is interested in joining our Medicare ACO for 2023, please contact your clinical performance consultant or email practicetransformation@azcarenetwork.org by July 15. On behalf of ACN’s physician-led Board of Managers and Executive Leadership Team, thank you for participating with ACN!

To further support your patient care, Arizona Care Network launched an additional value-added service this summer on behalf of your practice: HIPAA-secure patient outreach via text message and/or email at no additional cost to your practice. These communications provide your practice with an alternative, convenient patient outreach to help reduce scheduling burdens and potentially close quality gaps. Here are a few important aspects of this service:

  • Message content will strictly relate to appointment scheduling and/or care gaps (i.e., A1C, cancer screening(s), AWV, etc.).
  • All patient email addresses and/or phone numbers are collected (when available) in claims data from participating payors, or from members opting in to receive ACN’s email newsletter.
    • Contact information may be updated for patients by reviewing a patient’s medical record in the Electronic Medical Records (EMR), only if/when ACN receives approved remote EMR access from your practice.
    • Your practice may also provide a Microsoft Excel spreadsheet of patient names and contact information.
  • Patients can opt-out of receiving text messages and/or email reminders at any time.
    • Additionally, your practice may identify patients to remove from an outreach list when the patient identifies to your practice that he/she does not wish to be contacted.
  • Patients may reply to ACN via text or call our Concierge team at (602) 406-7226 for assistance in scheduling any appointment(s).

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

Per CMS guidelines, more than 26,000 Medicare lives covered under the Global and Professional Direct Contracting (GPDC) Model received a required notification confirmation letter earlier this summer. However, due to a CMS address error, some Medicare beneficiaries may not have received this required notification. CMS has notified ACN of the error and the beneficiaries who were affected. ACN will re-send the letter to affected beneficiaries, as determined by CMS. The revised letter includes a disclaimer noting the possible error, and that if a beneficiary previously received a letter earlier this summer, he/she can disregard this most recent version. The letter notified beneficiaries that his/her primary care doctor participates in Arizona Care Network. The letter also listed benefits and special programs available to beneficiaries at no additional cost: care coordination, home visits, concierge services, and more. In this year’s mailing, beneficiaries also received:

For questions or more information, please contact your Clinical Performance Consultant or email practicetransformation@azcarenetwork.org.

With summer’s sweltering heat in full swing, ACN would like to remind your practice that Social Determinants of Health (SDOH) can have an adverse effect on your patients’ health and ability to receive timely, cost-effective care. SDOH are physical, social, and economic barriers which may impede a patient’s ability to access the care he/she needs. These include (but are not limited to):

  • safe housing
  • transportation to/from a provider office, grocery store, and/or pharmacy
  • access to quality foods
  • mental or emotional behaviors (anxiety, depression, loneliness, etc.)
  • financial limitations and/or job opportunities
  • language or literacy

Any/all SDOH can have a detrimental effect on a patient’s health, contribute to a physical or mental condition, or prevent the patient from seeking the care he/she needs:

  • Patient is not consistent with appointments
  • Patient does not follow up on labs or referrals
  • Patient does not take medications as prescribed
  • Patients does not present as alert, well-nourished, and well-groomed
  • Patient does not adhere to prescribed diet
  • Patient does not follow up at ED if provider recommends it

An annual SDOH Screening for any patient 18+ years old is recommended. Any member of a patient’s care team may conduct a screening at any time. Additional Support Available from ACN As an included patient benefit of your practice’s participation with ACN, no-cost Care Coordination services can help your patient(s) in scheduling appointments, ensuring necessary transportation, and other available services that may support your patient and supplement your care plan. You may contact ACN’s Care Coordination team at (602) 406-7226 or carecoordination@azcarenetwork.org. Available Resources

Additional resources are also available from your Clinical Performance Consultant or by emailing practicestransformation@azcarenetwork.org.

Network News Roundup

  • 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 eight Medical Neighborhood Maps are available to your practice anytime. 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.
  • Providing ACN with authorized remote EMR access can help ease administrative and scheduling burdens on your practice. Remote EMR access allows a specific ACN Quality Team member to identify possible Hierarchical Conditioning Category (HCC) coding opportunities for Medicare members, and potentially identify/close quality gaps. Please contact your Clinical Performance Consultant or email practicetransformation@azcarenetwork.org if your practice wishes to participate.
  • Save The Date: Phoenix Children’s Care Network (PCCN) invites all providers to its inaugural Pediatric Population Health Symposium. This Zoom event is scheduled for Oct. 5 from 6-8 p.m., and will bring together many of Arizona’s key healthcare stakeholders to present on prevalent and relevant topics that face our community’s pediatric patients and healthcare systems. A list of key topics and speakers is available here. Watch for more information and a registration link in upcoming communications, as well as the September newsletter.
  • Abrazo hospitals earned the American Heart Association/American Stroke Association’s Get With The Guidelines® quality achievement awards for commitment to stroke patient treatments. Abrazo Central Campus earned the Stroke Gold Plus with Advanced Therapy, and Type 2 Diabetes Honor Roll awards. Abrazo West Campus received the Stroke Silver Plus, Target: Stroke Honor Roll Elite, and Target Type 2 Diabetes Honor Roll awards. Abrazo Arrowhead Campus received the Stroke Gold Plus with Target: Stroke Honor Roll Elite Plus, and Target: Type 2 Diabetes Honor Roll awards.
  • Abrazo Arrowhead Campus offers Aquablation therapy using waterjet ablation for treatment of lower UTI symptoms due to benign prostatic hyperplasia (BPH). Aquablation therapy is a minimally invasive treatment that uses the power of water delivered with robotic precision to provide symptom relief, regardless of prostate size or shape. The AquaBeam Robotic System used in the therapy is the first FDA-approved surgical robot utilizing automated tissue resection for UTI and BPH. It combines real-time, multi-dimensional imaging, automated robotic technology, and heat-free waterjet ablation technology for targeted, controlled, and immediate removal of prostate tissue.
  • Barrow Neurological Institute and Mercy Care are offering the TBI & Domestic Violence Primary Care Provider Forum, a CME opportunity course for Primary Care Providers This no-cost, “virtual” course provides information about domestic violence, recognizing traumatic brain injuries, and medical, psychiatric, and rehabilitation care needs for patients with a TBI due to domestic violence. Speakers will help 1) describe ways to identify signs of abuse and demonstrate understanding of traumatic brain injury diagnostic criteria; 2) apply knowledge of traumatic brain injury identification and treatment options; and 3) implement strategies for facilitating resources for patients who are victims of domestic violence and/or traumatic brain injury. More information and registration is available here. You may also contact cme@barrowneuro.org with any questions.

Welcome, New Provider Organizations!

  • Apex Vein & Vascular Institute (Phoenix)
  • Arizona Neurology Care (Queen Creek, Tempe)
  • Elite Vein Clinic (Chandler, Phoenix, Scottsdale)
  • Sonoran Pediatric Endocrinology & Diabetes Institute (PCCN)
  • Tri-City Cardiology Consultants (Gilbert, Mesa, San Tan Valley)
  • Tri-City Surgical Centers (Mesa)

You can also view a list of provider organizations no longer participating with ACN in 2022.