1. Annual Member Meeting May 9, 2018
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2. Agenda Welcome Introductions Annual Member Update Treasurer’s Report
Closing Remarks
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3. Questions Please submit questions to contact@qcpi.org
Questions will be addressed after Officer reports
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4. Current QCPI Board of Directors
Miles E. Brett, MD
Joel A. Goldstein, MD
S. Catherine Alexander, MD
Kenneth E. Jones, MD
Michael J. Kinstler, MD
Joseph M. Rosenfeld, MD
Jitendra “J.T.” Singh, MD
Imani D. VanNoy, MD
J. Vincent Vigil, MD
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5. Bylaws Amended and QCPI Board of Directors
Bylaws were amended as of March 21st; notice of this amendment was sent to the network
The size of the Board was reduced from 9 to 5 members to reflect changes in QCPI’s manner of conducting business and to make transacting business more efficient
Immediately following Annual Meeting, new Board of Directors will be:
Miles E. Brett, MD
Joel A. Goldstein, MD
Michael J. Kinstler, MD
Imani D. VanNoy, MD
J. Vincent Vigil, MD
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6. QCPI Staff
Stephanie Atkinson, Executive Director, Physician Network Director
Steve Robey, MBA, MHA, Director, Medical Analytics
Rebecca Warthen, RN, Clinical Nurse Director
Cindy Toler, Sr. Provider Relations Manager
Sherry Vallee, LPN, Clinical and Network Nurse Coordinator
Vicki Smith, RN, Clinical Nurse Coordinator
Jodi Duncan, Network Service Representative
Vera Copeland, CMA, Executive Assistant
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7. Products BCBSGA HMO/POS Contract:
BlueChoice Healthcare Plan (HMO) and BlueChoice Option (POS)
Blue Open Access HMO/POS
Includes State Health Benefit Plan (POS)
Exchange Products
Pathway Open Access HMO
Pathway Guided Access HMO
Growth is concentrated in the Commercial Open Access (POS), SHBP (POS) and significant growth in Exchange products; Guided Access is only available in Bibb, Houston and Richmond counties
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8. Network Updates New Team Member Going Paperless
Jodi Duncan, Network Services Representative
Going Paperless
Implemented Electronic Document Management System
Streamlined Credentialing/Contracting
In Development
Recognize & Reward Audits
Annual Physician Quality Report
QCPI needs your current address. Please send to
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9. New Address QCPI is moving just up the block on Peachtree Road!
Effective May 21st, QCPI’s new address will be:
3445 Peachtree Rd, NE
Suite 1200
Atlanta, GA
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10. Central mailbox for provider inquiries (non-delegated groups)
BCBSGA
BCBSGA
Restructured its Provider Solutions team (f/k/a Provider Relations) to improve response time to provider issues
Central mailbox for provider inquiries (non-delegated groups)
2018 Upcoming Provider Town Hall Meetings
May 15th | The Hughston Foundation, Columbus, GA
June 12th | St. Mary’s Healthcare, Athens, GA
July 17th | Gainesville Civic Center, Gainesville, GA
August | TBD, Augusta, GA
September | TBD, Macon, GA
October | TBD, Atlanta, GA
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11. Free Standing Imaging Options
American Health Imaging
Call 855-MRI-CHOICE or Visit AmericanHealthImaging.com
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12. Free Standing Imaging Options
Scheduling: (855)
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13. VillageMD collaboration is ongoing
For PCPs who do not join VillageMD, there is no change in how to access Blue Cross HMO products – still go through QCPI
QCPI continues to work actively on behalf of all PCPs in the QCPI network
VillageMD remains an option for QCPI MDs
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14. Clinical Quality Integration
Clinical Quality Integration is a process which aligns a physician group’s quality of care with its financial reimbursement on BCBSGA managed care products
CQI Program includes both Open Access and traditional HMO/POS products
Network is clinically and financially integrated
2018 CQI Metrics communicated in February – visit qcpi.org
Technology Metric
Availity Usage: for member eligibility, benefits and claim inquiries instead of using the telephone
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15. Clinical Quality Integration
Blue Open Access HMO/POS Products:
Commercial HMO/POS: PCP groups are re-tiered, at least annually, to one of three fee-for-service fee schedules based upon a subset of metrics – applied uniformly to groups
BlueChoice Healthcare Plan (HMO)/ BlueChoice Option (POS) -Traditional HMO/POS Products:
Differential cap tables and fee-for-service fee schedules assigned annually based upon a subset of metrics – applied uniformly to groups
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16. Clinical Quality Integration
Physician Quality Report (PQR):
Communicates benchmark data to help you understand key factors – quality, utilization, and resource use with the goal of continuously improving the quality of your care
Provides feedback to you on how you manage your HMO/POS patient panels relative to other QCPI PCPs
Fee Schedule determinations are communicated with Physician Quality Report
2017 Physician Quality Report / notification of new fee schedule assignments will be communicated this summer
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17. 2018 Incentive Programs
Focused, targeted measures with clear guidelines, rules and potential rewards
Program structure returned to Recognize & Reward Program format
Programs are open to participants, regardless of panel size, and measurement will be done at the physician level
Program requires active opt-in and self-reporting
Gives incentives to you for providing documented, measurable preventive care to your patients
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18. Adult: 2018 Incentive Programs Pediatric: Program ends: July 27, 2018
Breast Cancer Screening
Online reporting system is now live
Website:
Pediatric:
Pediatric Developmental Screening
Program ends: July 27, 2018
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19. Communications Provider Outreach: QCPI Monthly Newsletter www.qcpi.org
QCPI network staff is available
Phone
Onsite visit upon request
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20. Treasurer’s Report Report given by Dr. Kinstler
Dr. Joel Goldstein, QCPI Treasurer, is out of town
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21. Please send questions to contact@qcpi.org
QCPI is always interested in knowing what physician members are thinking
If your questions have not been answered tonight, please call our office at , send a fax to OR send an to
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22. Closing Remarks Stipend for attending tonight’s meeting
2018 Incentive Program questions?
Contact Rebecca Warthen, RN at or for assistance
Network issues?
Contact Cindy Toler at or for assistance
Adjourn
THANK YOU
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