Practice Tactics

Claims Processing Update

Umpqua Health Alliance is changing the way the secondary payment amounts are calculated on claims when Medicare is primary. The Medicare with-hold amount will be included in the calculation of what is considered Medicare’s payment amount. For more information on how secondary claims are processed, please contract our Customer Care Department at 541-229-4842 or email them at  UHAClaims@umpquahealth.com .

Medication Therapy Management (MTM) Program: Now Enrolling New Patients

The UHA pharmacy team has successfully assisted several members to overcome barriers to medication adherence and has resolved medication related problems during telephonic comprehensive medication reviews. This January we sent MTM information letters to patients with recent emergency room visits related to COPD or diabetes in an effort to optimizing medication use and reduce the rate of readmission.

• Providers seeking assistance identifying, preventing, and resolving medication-related problems for their patients are encouraged to complete a referral using the Community Integration Manager (CIM) platform by choosing the Medication Therapy Management referral type and selecting the specific services requested under the diagnosis section. Alternatively, a completed MTM Referral Form may be submitted via email UHPharmacyServices@UmpquaHealth.com, or via fax to (541) 677-5881.
• Reasons for member referral to MTM may include:
  • A high risk of developing medication-related problems
  • An identified medication-related problem
  • Medication adherence issues
  • Polypharmacy related to the member having two or more chronic conditions and eight or more maintenance medications.

Clinical Corner

Advanced Care Planning

Umpqua Health Alliance has partnered with Iris Healthcare to offer Advanced Care Planning (ACP) for UHA members.  ACP includes exploration of personal preferences with development of documents that include Advanced Directives, POLST, Living Will, and Power of Attorney that are shared with hospital and clinic at point of care.  Clinicians all agree that ACP is desired, but lack the time and ability to complete.  Iris has trained healthcare facilitators that engage patients and their families at times convenient to them, utilizing video/phone conferencing.  More information about Iris ACP can be found here.

UHA Care Coordinators have started offering ACP to high acuity members.  Providers can refer patients they identify as priorities for this specialized service to CareCoordination@umpquahealth.com.

UHA plans to expand ACP options to the greater community in the near future. We will keep you informed.

Diabetes Prevention Program

Treatment of Prediabetes/Gestational diabetes with a comprehensive lifestyle program has shown to reverse the progression to diabetes in up to 60% of participants.  The OHP covers Diabetes Prevention Programs (DPP) that are certified by the CDC.  Cow Creek Health and Wellness Center has offered this program to its tribal members for many years and will be offering this year-long program to all qualified UHA members in 2021.

Consider referring all of your patients with these diagnoses to DPP!  Visit the DPP page on the UHA website: https://www.umpquahealth.com/diabetes-prevention-program/

For an excellent review of the available and upcoming COVID-19 vaccines:         

The January 2021 issue of the Oregon State Drug Review has been posted to:

http://pharmacy.oregonstate.edu/drug-policy/newsletters

On the Lookout

For the latest information on COVID vaccination in Douglas County, visit Douglas Public Health Network: http://douglaspublichealthnetwork.org/

CME for Thee

Patient-centered counseling virtual trainings

(no-cost CMEs available*)

Who: Primary care, behavioral health and dental care providers; clinic staff; and traditional health workers serving Oregon Health Plan (Medicaid) members who want to learn and practice motivational interviewing and other patient-centered skills to support patients’ health goals.

What: Dana Sturtevant, MS, RD, will lead full-day virtual trainings focused on motivational interviewing and other patient-centered counseling skills. The session will focus on increasing your confidence and skills to facilitate conversations with patients about sensitive topics. Examples will draw from tobacco use, diabetes management, adolescent immunization, well visits, and other priority topics related to CCO incentive metrics and COVID-19.

When: 9 a.m.–4 p.m. each day

• Wednesday, April 7
• Thursday, April 29
• Tuesday, May 18
• Thursday, June 10
• Tuesday, June 29

Register here: https://www.oregon.gov/oha/HPA/dsi-tc/Pages/Patient-Centered-Counseling.aspx

Questions: Contact Laura Kreger at Laura.E.Kreger@dhsoha.state.or.us or 503-487-7409.

Trauma Focused-Cognitive Behavioral Therapy (TF-CBT) OHA Sponsored      

Overview:

Trauma Focused-Cognitive Behavioral Therapy (TF-CBT) is a highly rated, evidence-based therapy designed to treat children ages 3-17 who have experienced trauma. TF-CBT treats children with an array of trauma histories, including children with multiple and complex traumas in their lives. To learn more about the TF-CBT model, please visit: https://tfcbt.org/

This course is designed for Oregon mental health professionals who work with children who have experienced trauma. It is an intermediate level course.

Cost and Prerequisites:

No charge: This registration includes up to 20 hours of virtual training and up to a year of consultation, a $600 value.

(Participants are responsible for Pre-training expenses of approx. $75, and Post training certification expenses for licensed therapists approx. $250)

Dates and Registration*:

• Go to www.tfcbtconsulting.com
• Click on “Registration”
• Scroll down to the “Oregon Health Authority” section of the page
• Upload the requested documentation (TFweb, receipt, license/QMHP, attestation)
• *You will receive an email confirmation of your registration within 1 week of uploading your completed application.

The content and total training hours are the same in each option. Each cohort will hold up to 25 registrants. Two additional training cohorts will be offered in 2021. Dates and times TBA.