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4 Ways To Earn More in 2018

Date: 01/16/18

We know that our statewide network of healthcare providers are one of our most important partners in transforming the health of Louisiana residents. That’s why we want to make sure we are committed to giving our providers access to the tools, resources and data they need to deliver quality, accessible care to our members.

It’s also why we reward our providers for achieving quality care and performing certain services! Here are 4 ways you can improve your earnings as a Louisiana Healthcare Connections network provider in 2018:

Number 1: Perform certain services

As a Louisiana Healthcare Connections network provider, we’ll reward you for performing and documenting the following services:

  • Post-partum visit (post-partum only): $50
  • Cervical cancer screening: $20
  • Breast cancer screening (mammogram): $20
  • Provider-submitted Notice of Pregnancy form: $75
  • Administration of 17P (each injection) and other antenatal progesterone: $10

Number 2: Reduce non-emergent ED utilization

Numerous studies have shown that patients have better outcomes when they have the benefit of receiving personalized, preventive care in the primary care setting. Our network providers who effectively reduce non-emergent Emergency Department (ED) utilization among their patient panels receive a $.50 Per Member Per Month (PMPM) incentive.

To help you identify and address ED utilization trends, you have access to a comprehensive, timely ED data report via our secure provider portal that lets you know when their patients have presented in an ED. In addition, we alert our providers when patients in their panels have had three or more ED visits in a 90-day period.

We also provide services such as care management and patient educational pieces to support you in reducing non-emergent ED utilization. When used together effectively, these tools – the data reports, member services, ED alerts and patient education – help you reduce non-emergent ED use and increase your PMPM earnings!

Number 3: Offer after-hours care

Access to primary care is key to improving the health of your patients – our members. Multiple studies have shown that expanded office hours contribute to improved care accessibility, greater outcomes and higher patient satisfaction. This is why we offer increased rates for after-hours care! This higher reimbursement ($25) is awarded when you use one of the following CPT codes:

  • CPT 99050: Services provided in the office at times other than the regularly scheduled office hours, or when the office is normally closed, in addition to basic service
  • CPT 99051: Services provided in the office during regularly scheduled evening, weekend or holiday office hours, in addition to basic service

Number 4: Meet incentivized HEDIS measures

Providers play a crucial role in improving the health of our members, and we strive to support your efforts to drive improvements in quality and outcomes. That’s why we track and offer PMPM incentives for key HEDIS measures:

  • Well child visits (Ages 3, 4, 5 and 6)
  • Adolescent well care visits
  • Chlamydia screenings in women
  • Adult access to ambulatory care
  • Comprehensive diabetes care

To help our providers identify opportunities to address care gaps related to these measures, and thus increase their PMPM earnings, we provide access to comprehensive HEDIS data reports in our secure provider portal. We also have a statewide team of dedicated provider consultants who are at the ready to visit your practice and help you identify ways to increase your HEDIS scores and your PMPM incentives.

We’ve Got Tools To Help You Succeed!

Don’t forget – you can use our secure Provider Portal to access valuable, timely data reports to help you identify and address care gaps, HEDIS performance measures, PMPM incentive earnings, and ED utilization rates among your patients – our members! If you need assistance registering for the Provider Portal, or if you would like to request portal training for your staff, please contact your dedicated Provider Consultant or call Provider Services at 1-866-595-8133.

We also offer many free training and educational opportunities for providers, both on-site and via webinar. These trainings, many of which offer CEUs, are designed to support you in delivering quality, accessible and integrated care to your patients – our members! If you’d like to register for a training session, visit www.EnvolveU.com. Questions about training opportunities and requests for on-site training can be sent via email to clinicaltraining@cenpatico.com.