June 2023

Human papillomavirus (HPV) infection affects a large percentage of the population and can cause six types of cancer, as well as genital warts.

 Approximately 2,800 New Yorkers are diagnosed with an HPV-related cancer each year.
 
The HPV vaccine is safe and effective in preventing HPV infections and cancers, but HPV vaccination rates continue to be much lower than the rates of other routinely recommended vaccines for adolescents in New York State (NYS). Only 40.2% of 13-year-old adolescents in NYS have completed the HPV vaccine series, leaving most of that age group unprotected from future HPV infections and cancers.
 
The American Academy of Pediatrics, the American Cancer Society, and the National HPV Vaccination Roundtable recommend starting the series at age 9 for girls and boys, which provides more time for completion of the series, decreases questions about sexual activity, decreases requests for only the “school-required vaccines,” increases the likelihood of full vaccination before first HPV exposure, and is highly acceptable to systems, providers, and parents. One in five vaccinating providers are already administering the HPV vaccine at ages 9 to 10, and half are willing to recommend it at age 9.
 
How you can help
Health care providers can help prevent cancer by talking to parents or guardians about the importance of the vaccine to reduce the risk of HPV-related cancer. Starting the HPV vaccination series at age 9 can increase the percentage of patients that are up to date by age 13, according to the latest research.
 
Learn more

• Download and circulate this letter by the New York State Cancer Consortium and the New York State HPV Coalition.

• Learn more about starting the HPV vaccine series at age 9 campaign from the National HPV Vaccination Roundtable

• Review the CDC’s Child and Adolescent Immunization Schedule by Age

• Attend the June 14 Office Matters for Pediatric Practices live webinar, where you can learn more about this campaign. Register here.

Since the introduction of the Brook+ Diabetes Prevention Program to Independent Health members in December of 2020, key measures continue to show that its digitally-based lifestyle change curriculum is helping Independent Health members increase their physical exercise and lose weight:

• 11,358 members have enrolled in the program since 2020.
• More than 9 out of 10 participating individuals have lost weight.  
• The average weight loss of members who have completed the program is 10%.

Brook+ a fully digital Diabetes Prevention Program (DPP) patients can use anytime, anywhere. It's recognized by the Centers for Disease Control and Prevention (CDC) to help participants lose weight (see infographic) and avoid chronic conditions. According to the CDC, participating in a DPP like Brook+ can reduce the risk of type 2 diabetes by up to 58% (71% for adults over 60 years old).
 
Primary care physicians have also found Brook+ to be extremely motivating to their patients who have prediabetes. Susan Baldassari, M.D. has seen how Brook+ supports her efforts in making sure her patients are on track in addressing prediabetes.  “In the past, we could counsel the patient with prediabetes: exercise more, reduce your carbohydrates and warn them that prediabetes can lead to diabetes,” she says.  “Now with Brook+, we doctors can intervene with a solution that can reverse this course. Patients receive lifestyle changes with the Brook+ program plus a digital scale and Fitbit that keeps them engaged.”
 
Brook+ is available to Independent Health members who meet CDC eligibility requirements. With tools and support to help members achieve real and sustainable health goals, we are proud to offer the Brook+ healthy lifestyle program to eligible members at no additional cost.
 
If you are interested in working with Brook to encourage you Independent Health patients to participate, please email Kristin Crosby at kcrosby@brook.health.

It is important to check WNYHEALTHeNET before having the patient sign the PCP change form.  If the patient already has the physician listed, there is no need to send in the PCP change form. 

 We receive many change forms on which the PCP is already listed; by checking first, this can eliminate some administrative work.

It is also important that you are using the most up-to-date PCP change form. To download it, log into your account; from the landing page hover Office Management - click on Office Forms -  click on Administration Forms - then download the Primary Care Physician Change form. 

The most up-to-date PCP change form allows us to make sure we are assigning the patient to the correct location, especially if a physician works at multiple locations. 

PCP change forms are typically processed within three business days and a double check can quickly be performed by using WNYHEALTHeNET. You can also check by using your bi-weekly Physician Enrollment Roster or by checking your provider portal performance reporting. (Data lag of 60 to 90 days)
 
Lastly, it is important that the form is complete.  Many times the two pieces of identifying information are missing for the patient (name and ID number) and the physician’s name and NPI.  Make sure the patient has signed the form.
 
Questions?  Email engagement@independenthealth.com

We invite all Pediatric and Family Practice office staff and providers to attend this Office Matters webinar developed specifically with pediatric topics.

REGISTER HERE
  
The agenda includes:
 
Welcome and Introduction
Deirdre Wheat, M.D., Medical Director, Quality & Population Health Management, Independent Health
 
Human Papillomavirus (HPV): “Start at 9” Campaign
Manika Suryadevera M.D., The American Cancer Society
 
Chlamydia Coding Tips
Jean Cosgrove, Physician Engagement Specialist, Independent Health
 
Asthma Medication Ratio (AMR) Strategies for Success
Joshua Sawyer, PharmD, Medication Therapy Management Pharmacist, Independent Health
 
Behavioral Health Programs at Independent Health
Elizabeth Scime, LCSW, Director, Behavioral Health Independent Health 
 
Metabolic Monitoring for Children & Adolescents on Antipsychotics (APM)
Joshua Sawyer, PharmD, Medication Therapy Management Pharmacist, Independent Health
 
Project TEACH (Training & Education for the Advancement of Children’s Health) Primary Care Physician resources
Michele Phillips, Senior Project Director at Project TEACH
 
Family Peer Support Services
Heather Wood, Family Peer Advocate Supervisor, New Directions
 
 After registering, you will receive a confirmation email containing information about joining the webinar

The Federal No Surprises Act and New York state regulations require health plans to display participating providers’ website and contact information on the health plans’ websites.
 
To comply with these requirements, we are asking our participating providers to complete an online questionnaire as soon as possible.
 
An authorized representative of your practice or facility must complete this questionnaire, which asks for your organization’s website and an email address for general inquiries. 
 
Your practice’s website and e-mail address will appear with your practice’s name and address in the Find-a-Doctor section of Independent Health’s website.
 
Watch your email for more information; or you may complete this questionnaire here.

An article in last month’s SCOPE gave an overview of how the Health Care Services and Population Health Management Departments deploy various tactics to encourage members to take a more active role in their health.

During the month of June, Independent Health will be conducting three member engagement/outreach campaigns.  These campaigns are described below.

Falls Prevention Campaign
This campaign will have two components: an email campaign and outreach by telephone.
Both the emails and phone calls will communicate the importance of discussing the member’s risk of falls with their provider. This will include some educational materials from the CDC and a call to action to have a conversation with your doctor.
 
Target Members: 

• Email – all Medicare members over the age of 65
• Outbound Calls – Targeted 1,500 Medicare members who were statistically chosen based on fall prevention criteria 
• Timing  - Both components will begin early June and occur throughout the month of June.

 
Healthy IDEAS Intervention for Members with Heart Failure
This intervention targets Medicare members with Heart Failure who also have a depression diagnosis to help link the member to the WNYICC Healthy IDEAS program to help manage symptoms.
 
This campaign is an outbound call completed by the Behavioral Health Case Management team to provide information and if appropriate, link the member to the WNYICC Healthy IDEAS program.
 
Target Members:

• Medicare Advantage HMO & PPO members who have a diagnosis of Heart Failure and a Major Depressive Disorder Diagnosis 

Timing: - Mid-June
 
Medicaid Health and Recovery Plan (HARP) Performance Improvement Plan Call Campaign
A HARP member is an individual who has significant behavioral health needs. Their care and services are focused on managing their physical and mental health and substance use services in an integrated way.
 
We will conduct a phone call campaign to HARP members with diabetes who have a gap for either A1c or Blood Pressure. A1c and blood pressure gaps are defined as the member either having a screening gap, or a lab value that is in poor control. The goal is to provide members with education and connect them with their PCP.
 
Timing: We expect to launch these calls in the next couple of weeks.
 
Be sure to watch upcoming issues of Scope to keep up-to-date on the More to come in future editions.

Keep up-to-date with the following formulary changes effective June 1, 2023:

• Medicare Advantage individual and group members 
• Pharmacy Benefit Dimensions 5-Tier formulary 
• Pharmacy Benefit Dimensions 3-Tier formulary

View the current versions of Independent Health’s policies when logged in to our provider portal.

Magellan Rx, administered by Magellan Rx Management, reviews select specialty drug prior authorization requests on Independent Health’s behalf.  View Magellan Rx policies here.

Check back next month for Independent Health featured articles.