Inland Quality Collaborative Session 1 - May 7: HCC Coding Improvement

The Inland Quality Collaborative started off it’s first 2008 session in Riverside on HCC Coding Improvement with Vijay Prabhaker and Carol Olsen, CPC, from the Coding Source along with participant presentations from Kaiser Riverside and Choice Medical Group on how they worked with providers/practices to improve HCC and P4P coding. The agenda, materials and resources are available below for download.

Session 1 Agenda

Presentation: HCC Coding Improvement & Documentation Improvement Plan - Vijay Prabhaker & Carol Olson, CPC, The Coding Source

Presentation: Coding Tips - Terence Shum, MD, Kaiser Permanente Riverside

Resources

Health Net Risk Adjustment Info

WellPoint Risk Adjustment Info

Kaiser: E&M Coding Review Tool

Kaiser: E&M History & Physical Exam Pocket Card

Kaiser: E&M History of Present Illness & Review of Systems Pocket Card

Kaiser: E&M Medical Decision Making & Risk Table Pocket Card

Kaiser: CKD - DM Documentation Guidelines

Kaiser: Major Depression & Drug/Alcohol Abuse Documentation Requirements

**Additional recommeneded HCC resources:

HCC Coding Tools - SCAN Health Plan: Updates, forms, provider tools, presentations, coding newsletters, and ICD-9 coding guidelines. 

HCC Blog: Regularly updated blog on all things related to Medicare Advantage risk adjustment.  Author: Matt Yuill, MD, CPC  - Founder of SearchICD9.com (another great tool!); CEO of ChartDrive, LLC, a medical software company, and Chief Medical Information Officer of HCC Administrators, Inc. based in Los Angeles. 

Download Materials: Inland Empire Healthcare Quality Conference - March 20

click here for more pictures from the conference

Agenda

Keynote presentation: Building on our strengths: Quality in the Inland Empire - Kiki Nocella, PhD, UC Riverside

Panel I: How To Improve Clinical Care
Improving Diabetes Care in a Small Practice - Lesley Po, MD, Molina Medical Group
Tools/Resources:
Foot Exam Form
DocSite Registry Overview
Sample Visit Planner
Sample Patient Flow Sheet
Sample Outreach Report - HbA1c

Identifying Patients Needing Services - Debbie Church, Riverside Medical Clinic
Tools/Resources: Sample Ascender Reports

Spreading Effective and Efficient Diabetes Care (SEED) - Ken Beckerle, RN, Riverside County Regional Medical Center

Empowering and Activating Patients: Strategies for Health Care Providers - Rowena Bartolome, RN & Jeanie Taylor, RN, Kaiser Permanente Riverside

Panel II: How to Improve Patient Experience
Communication Enhancement Program - Brad Gilbert, MD, Inland Empire Health Plan

Ambulatory Care Clinic Redesign - Ken Beckerle, RN, Riverside County Regional Medical Center

Open Access - Robert Nelson, MD, Primcare of Citrus Valley

Getting to Advanced Access - Dennis Flynn, EPIC/Beaver Medical Group

Tips for Physician Recruitment & Retention - Lee Ounanian, MD, Beaver Medical Group

Inland Quality Collaborative Awardees

Additional References
Inland Quality Collaborative 2007 Summary
IHA P4P Coordinated Diabetes Care Domain

Speaker Bios

SAVE THE DATE! INLAND EMPIRE HEALTHCARE QUALITY CONFERENCE - THURSDAY, MAR 20, 2008 - Doubletree Hotel Ontario Airport - 9AM - 4PM

Join with other leaders in your community for the first region-wide conference on improving healthcare quality in the Inland Empire. This special event brings together local medical groups/IPAs, health plans, public hospitals, medical societies, as well as statewide healthcare organizations to foster cross-sector awareness and a rich learning environment focused on showcasing and sharing successful ways to improve healthcare in the Inland Empire.

• Learn and share good ideas, best practices and valuable resources to improve chronic disease care and patient satisfaction.
• Understand resources available in your community, where to find them, when to use them, and who to contact.
• Take away at least one idea to implement in your organization.

Who should attend? Senior leaders, healthcare administrators, quality managers, physicians, nurses, office staff - anyone interested in improving healthcare in the Inland Empire!

Who’s attending?
Beaver Medical Group
Blue Cross of California
Blue Shield of California
California Association of Physician Groups
California Department of Managed Health Care
Choice Medical Group
Health Net
High Desert Primary Care Medical Group
Ingram Micro
Inland Empire Health Plan
Kaiser Permanente - Riverside
Loma Linda University Health Care 
Office of the Patient Advocate
Pacific Business Group on Health
PrimeCare/NAMM California
Riverside County Medical Association
Riverside County Regional Medical Center
Riverside Medical Clinic
Riverside Physician Network
San Bernardino Medical Group
Southern California Edison
University of California, Riverside

Registration is FREE, but space is limited to 120 participants. To reserve your space or for more information, please contact Roza Do at rdo@pbgh.org, or 213.239.5049

The Inland Empire Healthcare Quality Conference is a collaborative project of the:  California HealthCare Foundation, California Association of Physician Groups, Blue Cross of California, Blue Shield of California, Health Net of California, Inland Empire Health Plan, PrimeCare Medical Network/NAMM California, Kaiser Permanente Riverside Medical Center, Riverside County Medical Association, Riverside County Regional Hospital Riverside Department of Public Health, California Quality Collaborative

Event Announcement: OSHA Annual Staff Training - January 30

The Riverside County Medical Association and San Bernardino County Medical Society are sponsoring a special training session designed to assist physician members and their office managers meet the OSHA mandate requiring annual training for all office employees on Wednesday, January 30th, 9AM-12PM at the Inland Empire Conference Center.  An annual training session is mandated by OSHA for all staff in every physician’s office by October of each year.  All attendees will receive a certificate of completion as training verification. Please note that while this documents Safety Training required by Cal-OSHA Regulations, it also must be supported by the employer’s in-office, site-specific Exposure Control Plan.

Presenter: Carrie Champness, RN, BSN, founder of Champs Solutions, a consulting firm of RNs that work with physician offices, urgent care centers, and surgicenters
to assist with management services, OSHA/HIPAA/State/Federal inspections and
education/training.

Topics to be covered:

• Code Red? Code Yellow? Code Green? Fire, bomb threats, violence in the workplace, evacuation.
• Exposure Control Plan: General facts, shots, “Do I have to?” Safety engineering devices, needle sticks, recordkeeping.
• Disasters: Internal and External
• Hazardous Communications: What are hazardous chemicals? What is a MSD? Hazardous drugs, personal protective equipment (PPE). Handling hazardous chemical waste/spills, mercury spills.

Time/Location:
9 am-12 pm (continental breakfast included)
Inland Empire Conference Center
3993 Jurupa Avenue, Riverside 92506 

Cost:
RCMA/SBCMS Member Fee - $15 per person/$10 each add’l same office
Non Member Fee - $50 per person/$25 each add’l same office

Register: Seating limited to 50.  Click here to download registration form.

Event Announcement: Certified Medical Coder (CMC) Program - March/April

The Riverside County Medical Association is offering a 5-day course to become a certified medical coder: Wednesdays, March 5, 12, 26, April 2, and 9, 2008. More physicians need Certified Medical Coders who are capable of understanding the complexities of the reimbursement process. Improve your practice’s financial health. Your skills will help guard against improper claim submission and contribute to a higher rate of paid claims for your physician’s practice.

Course Curriculum:

Medical Terminology for Diagnostic & Procedural Coding

• Roots, prefixes and suffixes
• Anatomy and physiology
• Body structure and body systems

ICD-9-CM Diagnostic Coding

• Coding conventions
• Guidelines from CMs
• Primary vs. secondary codes
• Signs/symptoms and ill-defined conditions
• Neoplasms and adverse effects
• Injuries, burns, fractures and wounds
• Supplementary classifications
• OB/GYN codes

CPT Procedural Coding

• CPT categories, format and guidelines
• Diagnostic vs. therapeutic services
• E&M services for all categories plus modifiers
• Surgical Coding guidelines and procedures
• Modifiers for surgical procedures
• Coding from chart notes and operative reports

Ancillary Services & Advanced Coding

• Maternity and delivery services
• Radiology
• Pathology & lab services in the physician’s office
• Medicine & intervention
• Coding problem set exercises
• Medical and surgical specialties

Time/Location: 
Five Wednesdays - March 5, 12, 26, April 2, and 9, 2008
8:00 a.m. - 4:00 p.m. each day (sign-in 15 minutes prior to each session)
Riverside County Medical Association
3993 Jurupa Ave., Riverside CA 92506

Cost:
RCMA/SBCMS member physicians/staff: $649
Nonmember physicians/staff: $949 (Registration fee includes breaks, lunch, certification exam)

Required Materials to bring to each class: CPT, ICD-9-CM Volume 1&2, HCPCS manual and medical dictionary

Register: Class is limited to 30.  Click here to download registration form.

Presented by Practice Management Institute and hosted by the Riverside County Medical Association and the San Bernardino County Medical Society

Questions: call (951) 686-3342

Teleconference Recap: EHR Implementation and Improving Clinical Quality

Studies show that EHR use does not necessarily improve clinical care (see article below). Kevin Manemann from St. Joseph’s Health System and Allison Foley, MD, from St. Jude Heritage Medical Group discussed how to avoid this trap and what to keep in mind during EHR planning and implementation to improve clinical quality.  Click below to download slides from the call, as well as a recent study from the Archives of Internal Medicine on this topic.

Using EHR for Population Management - lessons learned and examples of interventions

Linder JA, Ma J, Bates DW, et al. Electronic Health Record Use and the Quality of Ambulatory Care in the United States. Arch Intern Med. 2007;167(13):1400-1405

THe ABCs of QI: Basic Tools of Quality Improvement

The California Healthcare Foundation (through the California Improvement Network) and the California Quality Collaborative held a one-day training course on the basics of quality improvement, The ABCs of QI, on Dec 11 in Ontario.  Jeanie Taylor, Nursing Project Coordinator, and Rowena Bartolome, Director of Care Management/Population Care, from Kaiser Riverside served as faculty for the course, which drew 50 attendees leading improvement efforts within public and private health care organizations in the region and neighboring areas of Los Angeles and Orange counties, such as Riverside Medical Clinic, Arrowhead Regional Medical Center, Care1st Health Plan and Choice Medical Group.  Topics covered were:   the PDSA model for improvement, developing aims and measures, data collection and run charts, strategies for working in teams and action planning.  Click on the links below to download the agenda and some of the presentations.

Agenda

Model for Improvement

Aims - What Do We Want to Accomplish?

Data Collection for Quality Improvement 

Strategies for Getting Started

To download additional materials and tools from the training, click on the Resources tab at the top of the page or go to http://inlandquality.wordpress.com/resources/the-abcs-of-qi-presentations-and-tools/ 

HCC University: Coding Tools from SCAN Health Plan

HCC coding has been mentioned as a hot topic for many groups in the region. Thank you to the California Association of Physician Groups (CAPG) for pointing out some resources developed by SCAN Health Plan. The HCC University on the SCAN website offers a wealth of resources and provider tools for public consumption including forms, presentations for physicians and medical directors, coding newsletters, and ICD-9 coding guidelines.

 A useful tool to start with is the physician superbill which lists the current diagnosis codes to help providers document encounters more accurately.

 To access and download additional tools and resources, go to http://www.scanhealthplan.com/article/physicianshospitals/hccuniversity/
hccuniversity.html

Inland Groups Featured at IHA P4P Stakeholders Meeting for the 1st Annual Ronald P. Bangasser, MD, Memorial Award for Quality Improvement

 

Two Inland Empire groups were up on the podium at the annual IHA Stakeholders meeting on October 4th in Los Angeles (www.iha.org).  For the first time, awards were given to the physician groups who improved most from each of 8 regions in California.  The award is named after Ron Bangasser, MD from Beaver Medical Group in Redlands, who passed away this year after a long career promoting quality in healthcare for California and the nation.  Family Practice Medical Group of San Bernardino won for the Inland Empire, and Anita Silingo and Kevin Johnson were on hand to receive recognition with the other winners statewide.

Tammie Demny from Empire Physicians Medical Group (EPMG), Rancho Mirage (on the far right), presented on the panel “Patient Experience Interventions with Impact”, along with Camino Medical Group, Mills-Peninsula Medical Group and Pacific Business Group on Health. Tammie told the story of gaining commitment from an initially skeptical Board at EPMG to focus on improving patient service for their largely senior population. Now, everyone at EPMG, from the board down, is making contributions to improve patient experience.

Inland Quality Collaborative Session 3 Highlights & Pearls

The Inland Quality Collaborative held the last on-site of the year on November 7 in Riverside, but much enthusiasm remains among the participating groups to continue the learning exchange - stay tuned, because we’ll be holding a region-wide conference in March 2008 to bring together best practices from various healthcare delivery systems in the Inland Empire. 

Thank you to Raymond Abram and Kevin Johnson from Family Practice Medical Group of San Bernardino for sharing tips and resources on improving data capture/flow and population management, and Jeanie Taylor, Kaiser Riverside, and Roger Chene, California Diabetes Program, for sharing their diabetes care tools and community resources. Below are links to presentations, tools, and some pearls from the on-site session on what groups are working on (and what’s worked) in the following topics:

Session 3 Agenda & Presentations

Improving Diabetes Care/Chronic Care

Improving Patient Satisfaction/Access

EHR/IT/Coding

Organizational Improvement

Download complete summary