Welcome to the new edition of the Navigator monthly newsletter. In this month's edition of the Navigator you'll find information on the Provider Mix & Mingle, secret shopper, the provider spotlight and more.
If you want to learn more about any of the articles in this issue of the Navigator, don't hesitate to contact us.
Thank you, Colorado Access
NEED TO KNOW
Join us for a Provider Mix and Mingle
Thursday, December 5, 2019 4:00 p.m. - 6:00 p.m. The Bent Noodle Italian Restaurant 3055 South Parker Road Aurora, Colorado 80014
Please join us for an evening of networking with fellow peers from Regions 3 and 5 as well as Colorado Access staff members from several departments. Please join us as we Mix & Mingle!
The Department of Health Care Policy & Financing (HCPF) if currently recruiting for the third cohort of health centers to take part in the award-winning Adolescent Champion Modelin Colorado which will start in February 2020.
This multi-year project is being funded through support from HCPF with the goal of improving adolescent health in the state of Colorado. The University of Michigan’s Adolescent Health Initiativeis partnering with Dr. Paritosh Kaul, professor of pediatrics section of adolescent medicine at University of Colorado and Children’s Hospital, to replicate the model in Colorado.
Additional information is attached. If your practice is interested in participating please contact Natasha Brockhaus at HCPF.
Natasha Brockhaus ACC Program Administrator Health Programs Office Colorado Department of Health Care Policy and Financing 303-866-4059 natasha.brockhaus@state.co.us
Community Events IMPORTANT NEWS FROM ADVANCED PEDIATRICS: Great news! Our VFC flu vaccine is in our offices! If you have Medicaid or are uninsured you are eligible to receive VFC vaccines.
We are scheduling flu vaccine weekday appointments at all locations. Please call 303-699-6200 to schedule your child’s flu shot appointment.
Our quality management team maintains a systematic process to monitor and fulfill access to care standards and metrics for contractual requirements. We monitor access to care through a secret shopper program. This monitoring program includes various provider categories, including physical health and behavioral health, to ensure that our members have access to timely and appropriate routine and urgent services. Included below are the results of these secret shopper calls for fiscal year 2017 – 2019.
The tables provided display compliance with access to care standards by provider and appointment type, and the contractual standards used to measure these results. Providers are contractually obligated to meet these access to care standards.
Secret Shopper Results We conducted a total of 67 secret shopper calls across our RAE Regions and across our CHP+ HMO provider network. RAEs Regions 3 and 5 as well as CHP+ providers met the performance goals of 80% compliant secret shopper calls for the physical health access to care standards. However, overall BH behavioral health access needs further development and training to inform providers about access standards. In particular, many providers offer walk-in appointments and do not always provide a scheduled appointment against which we can measure timely access.
Members have reported long wait times for walk-in appointments limiting the member’s ability to get timely care.
COLORADO ACCESS PROVIDER SPOTLIGHT
Heartlight Family Clinic
The nine providers and five office staff at Heartlight Family Clinic specialize in primary and integrated behavioral health. Their providers include four family and adult nurse practitioners, two psychiatric nurse practitioners, one licensed marriage and family therapist, and two licensed professional
counselors (one of whom exclusively sees pediatric patients). The clinic has seen impressive growth in self-referrals to their in-house behavioral health providers. The clinic’s provider relations representative at Colorado Access is Elina Navarro, and she has been “instrumental in helping us learn the DAP website for our advanced payment model planning,” says Family Nurse Practitioner Katrina De Romana.
Heartlight also collaborates with AccessCare for psychiatric telehealth visits when appropriate. The
clinic further collaborates with local specialists for “curbside consults” on an as-needed basis. Heartlight will soon be offering a telehealth option for minor acute medical visits. It’s their hope that this will cut down on their no-show rate and can help convert appropriate late cancellations into telehealth visits.
Heartlight Family Clinic
Heartlight is actively contacting
their highest-risk patients to ensure follow-ups for their conditions. De Romana has noticed that many of Heartlight’s most difficult medical patients are getting better with the help of psychiatric evaluations and therapy. She believes that the mind-body connection is key to health risk reduction for many people, and notes that it’s been “very rewarding to finally have a positive impact for these patients right here in our clinic to improve their health and well-being.” A standout example of the mind-body connection at play at the Heartlight Family Clinic was
with a recent patient. A 67-year-old male had several significant health problems related to smoking three to four packs of cigarettes daily since he was a teenager. De Romana had been working with him for more than six months and finally got him down to one pack per day. His progress plateaued until De Romana referred him in-house to Amanda Turecek, Heartlight’s licensed marriage and family therapist. With the help of Turecek and individual and EMDR therapy, the patient is finally getting therapy to be able to quit smoking. To learn more about the Heartlight Family Clinic, visit their website at heartlightclinic.com.
