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May 15, 2019
Learn about 2019 watch metrics for SelectHealth Shared Risk Networks.

Shared Risk Networks:

Measuring Persistency for Appropriate Documentation and Coding

Participating providers in the Shared Risk networks (SelectHealth Advantage, Community Care, and Share) agree to support the 18 Shared Commitments, a value-based healthcare delivery model, for the members attributed to their practices. These commitments promote:

·         Clinical excellence, integration, and improvement

·         Patient access

·         Accountability, operational commitment, and mutual respect

In 2019, we are focusing on three watch metrics related to these commitments:

1.       Accurate and complete documentation and coding (persistency)

2.       Patient satisfaction

3.       Quality


For the first of these watch metrics, SelectHealth will be focusing on minimum persistency targets for appropriate documentation and coding. More details will be coming soon on the other two watch metrics, patient satisfaction and quality, as well as online dashboards for providers to track their progress.

What is persistency, and how does it impact patient outcomes?

Persistency refers to a chronic Hierarchal Condition Category (HCC) that was accepted by CMS in both 2018 and 2019. HCC has to do with a patient having a documented and accepted chronic illness in 2018 who has the same documented and chronic illness in 2019. To fall within the persistency metric, the chronic illness must be documented and accepted by CMS on a claim in 2018 and in 2019.

The Centers for Medicare and Medicaid Services (CMS) stresses that complete and accurate medical records foster more timely and appropriate care, which leads to improved patient outcomes. Additionally, persistency is key to our ability to identify and deploy appropriate resources to best meet individual SelectHealth Advantage (Medicare) members’ needs. These 2019 targets are:

·         40% by July 1

·         60% by September 1

·         70% by December 1


How is data gathered for this watch metric?

To start meeting these persistency targets, providers will need to submit information on SelectHealth Advantage patients with chronic conditions using the SelectHealth Advantage Value-based Care Form available at the Intermountain Reports Center (log in required). Review the Quick Guide: SelectHealth AdvantageValue-Based Care Form​ for help using this form.

How can a provider track progress?

View progress reports by following these seven steps:

1.       Go to the Intermountain Reports Center.

2.       Log in.

3.       Click on “View Report.”

4.       Select your clinic.

5.       Select “ALL” your providers.

6.       Select “ALL” patients’ names.

7.       Click “Run Report,” and print.

 

Questions? Contact Mitchell Davies at 801-442-7969 or via email at Mitchell.Davies@selecthealth.org.

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