News

January 1, 2022 Kidney Disease EVALUATION for Patients with Diabetes (KED)   HEDIS MEASURE: The percentage of adults ages 18 to 85 years of age with diabetes, as of December 31 of measurement year, who received a kidney health evaluation. BACKGROUND: Facts a Approximately 90% of those with early kidney disease don't know they have it. Approximately 1 in 3 adults with diabetes may have kidney disease or are at risk. Kidney disease  affects an estimated 37 million people in the U.S. (15% of the ...

December 22, 2021 Clinical Integration Payment 1 for 2021 McLaren Physician Partners (MPP) is pleased to announce the release of the MPP Clinical Integration (CI) Payment 1 of 2 for 2021. This payment is based on physician performance on quality measures and value-based payments received from February 2021 to July 2021. The total distribution amount is $8,172,000. As we transition to value-based payments our top performing physicians have received the following in this distribution: MPP would especially...

December 15, 2021 HCC (Hierarchical Condition Category) Coding The goals of value-based care programs are lowering health care costs and improving patient outcomes. Identifying patients at high risk of serious health events such as emergency department visits or inpatient admissions and preventing them is one way to reach the above goals. The McLaren High Performance Network ACO and the MPP Medicare Advantage gainsharing contracts are examples of value-based contracts. Regulatory agencies and payers use...

November 15, 2021 MHPN to distribute $2.5 million to ACO providers   McLaren High Performance Network, LLC (MHPN) is pleased to announce the release of the provider distribution of the 2020 ACO shared savings to our ACO member providers. The payout will consist of utilizing the Board approved methodologies for Clinical Integration payments based on McLaren Physician Partners (MPP) CI scorecard performance of participating physicians on related metrics and Medicare Beneficiary Attribution. The total...

July 26, 2021 Medicare ACO Beneficiary Notification   This is to advise you that MHPN will be sending your Medicare ACO (traditional Medicare only) patients a beneficiary notification letter as required the CMS Shared Savings Program. ACOs are required to notify beneficiaries, using the CMS template, of your participation in the Shared Savings Program. The template must be used as written by CMS and may not be modified. Notification will be done in two ways: • A written notice. The ACO or its ACO p...

Earlier this year in March, to improve the efficiency and effectiveness of access to communications and delivery of clinically pertinent information, MPP updated our website at mclarenpp.org to incorporate access to clinical education with individual user profiles for providers. Providers were asked to create their own user profile, including log-in and password, to get access to the members section of the website. If you have completed this, no further action is needed. If not, please go to mclarenpp.o...

FINANCIAL SUPPORT FOR MILLIONS OF HEALTH CARE PROVIDERS NATIONWIDE Up to 2% of patient revenue regardless of a previous disbursement.   Many health care providers are experiencing significant financial hardships in the COVID-19 pandemic. Congress provided $175 billion in relief funds to the U.S. Department of Health and Human Services (HHS) to deliver financial relief to hospitals and other health care providers, including those on the front lines of the coronavirus response. Since March, HHS, thro...

McLaren High Performance Network, LLC received a final MIPS score of 96.9 out of 100 for performance year 2019. This score was calculated based on performance in Quality, Advancing Care Information, and Improvement Activities. CMS categorizes any score greater than 75 as exceptional performance . Based on this performance, eligible providers in the McLaren High Performance Network will receive a 1.58% positive payment adjustment in Calendar Year 2021. The 2021 MIPS payment adjustments vary between -7% a...

Persivia’s CareSpace TM will assist McLaren to achieve even greater success in our value-based care models. The platform combines care coordination, real-time quality and utilization analytics and reporting, enhanced patient and provider engagement, and bundle payment management tools. Here are some of the clinical functionality we will realize following implementation: Automated Care Coordination work flows to improve efficiencies; allowing staff to spend more time managing patients Risk stratification...

PCP Value Based Reimbursement (VBR) & 2019-2020 Patient Centered Medical Home (PCMH) Designations The BCBSM Value-Based Reimbursement (VBR) program provides for fee schedule uplifts for PCMH, quality performance, cost, and provider delivered care management (PDCM), up to a total of 150% of the fee schedule. PCMH 15% Quality 5%-15% Cost 10% PDCM 5% Advanced PDCM 5% _____ Total = 150% Key Achievements: 89% of MPP’s participating primary care physicians are eligible for a VBR 21% received a VBR for exc...