A MONTHLY REPORT BY YOUR PEPS TEAM
TO : |
GLMS Members & Practice Staff |
FROM : |
Physician Education & Practice Support ( PEPS ) |
Stephanie Woods , GLMS Practice Resource Specialist |
RE : |
Monthly Update |
We look forward to sharing with you each month the most recent news and activities from the GLMS Physician Education and Practice Support Department .
HUMANA TO PARTNER WITH ORTHOPEDIC SPECIALTY GROUPS IN KENTUCKY AND INDIANA
In an effort to improve outcomes and costs for hip and knee replacements , Humana announced in April it is partnering with eight orthopedic groups in Kentucky and Indiana to implement a valuebased core model , rather than a fee-for-service model , for Humana Medicare Advantage members getting total hip or knee replacements .
In a press release , Humana said that this initiative will give providers “ robust data and analytics ” to better manage the entire care , starting with diagnosis and going through recovery . For further information and to see a list of the orthopedic groups involved , go to : http :// press . humana . com / press-release / humana-brings-value-based-orthopedic-specialty-care-indiana-and-kentucky
Dr . Val Slayton , Humana Medicare East Region Medical Director reported that there are some significant pilot projects beginning soon . One of them is an in-home respiratory program that will provide respiratory services , education and training in the homes of patients with significant COPD . Licensed respiratory therapists will be involved . Medication compliance and smoking cessation will also be included . Humana hopes to begin the project in June . A second pilot will be a smart phone based intervention for members with moderate COPD .
PROVIDERS PARTICIPATING IN ANTHEM NETWORKS ARE REMINDED TO UPDATE PRACTICE INFORMATION
At the April 11 , 2017 Anthem IIRC Meeting , representatives from Anthem shared that providers participating in Anthem Blue Cross and Blue Shield ( Anthem ) network ( s ) must provide 30 days prior notice to Anthem of changes and updates to their practice . This includes the addition or departure of a provider , adding or removing locations , closing your practice to new patients and other demographic changes . Promptness in alerting Anthem to these changes helps ensure that Anthem ’ s provider directory and claims systems remain up-to-date for the benefit of both patients and providers .
For further information : https :// central . provider . anthem . com / mwpmf / PMFControllerServlet
6 Fleur-De-Lis Connection JUNE 2017