CMS emphasizes services that impact patients’ health experiences, which in turn can affect treatment adherence and overall health. Coordination of care means knowing patients’ health needs and preferences and communicating them at the right time to the right people for the delivery of high-quality, high-value care.

We’ve posted to the Provider Portal the following newly developed resources, with several designed to assist in coordination of care efforts.

1. Improving Patient Experience Through Care Coordination – This one-page document addresses ways to improve efficiencies around care delivery and enhance patient experience, a key measure in the Consumer Assessment of Healthcare Providers and Systems survey that CMS sends annually to Medicare beneficiaries.
2. Enhancing Patient Outcomes Through Chronic Care Management Services – This checklist, pulled from the CMS Medicare Learning Network (MLN) Chronic Care Management Services booklet, offers tangible tools for effective chronic care management and care coordination activities.

3. Post-Acute Facility Documentation Form – Skilled nursing facilities and long-term care facilities can use this comprehensive form to easily submit essential documentation to Peoples Health to support patients’ ongoing care. The form is a companion piece to our Skilled Nursing Facilities – Submitting Authorization Documentation handout that outlines the required time frames for submitting documentation, as well as the required documentation types.

4. Identifying and Documenting Heart Failure, Chronic Obstructive Pulmonary Disease and Chronic Kidney Disease – This white paper provides information around symptoms and comorbidities, as well as common assessments and codes for these three conditions.

Get the one-pager and the checklist. Click the Resources tab, then Educational Resources. Look below the HEDIS and Stars heading.

Get the form. Click the Authorizations tab, then under Tips for Submitting Authorization Requests, select the SNF Authorizations and Recertifications link.

Get the white paper. Click the Resources tab, then Educational Resources. Look below the Health and Chronic Conditions heading.

Updated! We’ve also revised the Provider Portal User Guide. Refer to it for instructions (with screenshots) on how to use the many tools and resources available through the portal, such as those to submit and review authorization requests and view patient histories. Access it under the Resources tab and Administrative Info sub-tab.