News

MPP received a request for help from one of our members in delivering the message of why it is important to use the McLaren network. Patients are asking why it is beneficial for them to stay within our network. In response, we have created a patient-facing flyer that addresses reasons why patients should stay within the McLaren network. Excerpts from the flyer include the following: Getting your care from a McLaren provider helps me (your provider) provide you with the best quality care possible. One of...

McLaren planning to open a combination of retail health clinics, primary care and urgent care centers at Michigan area Walgreens Walgreens to purchase McLaren’s pharmacy files DEERFIELD, Ill. & GRAND BLANC, Mich. – Oct. 17, 2018 – Walgreens and McLaren Health Care, a fully integrated health network committed to quality, evidence-based patient care and cost efficiency, today announced that they have entered into a strategic collaboration focused on health service and pharmacy offerings. McLaren plans...

McLaren Physician Partners (MPP) and McLaren High Performance Network, LLC (MHPN) have continued an exciting Care Management expansion over the past quarter. In addition to Patient Navigators, we now also have Registered Nurse Care Managers and two Masters prepared Social Workers on board to help connect your patients to the appropriate level of assistance. As a department, our goal is to improve the overall quality of care and outcomes while reducing avoidable utilization.  Our Care Coordinators p...

The Blues of Michigan have released the results of the Specialist VBR program.  This program comes through the Physician Group Incentive Program (PGIP), administered by McLaren Physician Partners.  We are pleased to share that 404 specialists were awarded the VBR in 2018 through this program, an increase of 113 specialists from last year!  Physicians participating in PGIP through MPP earned $5 million in VBR revenue in calendar year 2016.  The PGIP ranks participating specialists int...

MPP has made several changes to the clinical integration scorecards for 2018 for both specialists and primary care providers. One of the new metrics under Membership is physician education. To satisfy the metric, a physician must attest to viewing two educational topics offered on the MPP website. To access the educational offerings: Go to www.mclarenpp.org From the home page Click Physician Education located at the top of the page. Fill in the required fields on the contact form, then Click Submit. Thi...

As previously reported in a September 2017 newsflash, the MPP Board of Directors’ approved three membership levels starting in 2018. These levels were created to provide the greatest opportunity for value-based payments to those that are most engaged and further along in their progress toward value-based care delivery. The membership criteria and level of commitment required increases with each higher level. Non-clinical Integration (Non-CI) Membership Level: Meets all basic MPP membership criteria. Par...

In 2017, McLaren Physician Partners and the McLaren High Performance Network launched a Transition of Care (TOC) program to serve as the foundation of its Care Management strategy. This program started with notifications to the practices of admission, discharge, and transfer (ADT) activity, progressing to risk stratification of all discharges, and assigning high-risk patients to a Nurse for Care Management. We are continuing to build our program by adding the next layer of services. “Care Management 2.0...

The MPP Care Coordination Team will begin providing a nurse‐led TOC encounter for high‐risk patients* discharged from a qualifying facility. The interaction will occur within two business days of discharge and include: New and existing medication education, questions and compliances Disease specific education and self‐management Review of discharge instructions to include social need and support programs that promote adherence to plan of care Follow‐up appointment scheduled (within 7 days) Contact with ...

Educational Objective:   This course offers an overview of Medicare Risk Adjustment and Hierarchical Condition Category (HCC) Coding.  Attendees will learn how to improve coding and documentation to ensure requirements are met. Business Case:   Proper documentation and coding of chronic conditions is essential for risk stratification of patients and appropriate funding from CMS/payors for physician gain sharing. Used to establish financial benchmark for CMS MSSP ACO Resets annually on Jan...

What is HCC coding? Risk adjustment and HCC coding is a payment model mandated by the Centers for Medicare and Medicaid Services (CMS) in 1997. Implemented in 2003, this model serves to identify individuals with serious or chronic illness and assigns a risk factor score to the person based upon a combination of the individual’s health conditions and demographic details. The individual’s health conditions are identified via International Classification of Diseases-10  (ICD –10) diagnoses that are su...