1. Annual Payor Conference
Welcome!
Lakeland Care Network
Annual Payor Conference
October 18, 2017

2. Lakeland Care Network - News
Newsletter
Monthly payor meetings
Midlevel credentialing initiative – 108 completed
Contracting update – Meridian, UHC, McLaren
Affirmant update
COMET

3. Lakeland Care Network - Quality Team

4. Programs We Offer – Elective Participation
Quality Improvement training
Care Management training and support
High Risk Care Management – Dual Population
Medical Home/Neighborhood transformation assistance
Patient Satisfaction
Payor incentive programs
CMS program updates/participation assistance
Coordination with the EPIC Connect IT and Integrated Analytics teams
Coordination with Affirmant (CIN) and The Federation (ACO)

5. Team Successes NCQA Level 3 Recognition for 3 practices
Edgewater Family Health, Stagg Medical Center, Lakeside Healthcare Specialists
Currently awaiting results for:
Coloma Medical Center
Community Medical Center
Southwestern Medical Clinic, Buchanan
Completed Wave 1 of the Lean for Clinical Redesign Program
Wave 2 is currently in progress
PGIP PCMH Recognition for 8 practices
9 practices participating in the Comprehensive Primary Care Plus (CPC+) Program through CMS
- CPC+, MIPS, the ACO/CIN

6. Affirmant – Our Clinically Integrated Network
Lakeland Care Network
Sparrow Care Network
Bronson
Henry Ford Allegiance
Covenant
CIN
Mid Michigan
Henry Ford
Something about a CIN

7. Affirmant & The Federation ACO
Lakeland Care Network
Sparrow Care Network
Bronson
Henry Ford Allegiance
Covenant
CIN
Mid Michigan
Henry Ford

8. Quality Team - Network Updates
Patient Satisfaction Collaboration Opportunity for Office Managers w/ Tom Jeffrey, Sullivan Luallin President
November 21st at Hilton Garden Inn
Invitations to follow
Lean for Clinical Redesign
Accepting interested practices for Wave 3 beginning January 2018, and Wave 4 beginning May 2018
Quarterly Outreach
Reach out to connect with us for Quarter 4 outreach
PGIP Capability Renewal
Will be coming around to practices in December to update capabilities

9. Quality & Care Management Contacts
The Team
Emily Ulrath – Payer Programs & Lean Coach
Jordan Zaluckyj – Medical Home, Patient Experience, & Lean Coach
Rachel Sunday – CMS Programs & Lean Coach
Karen Riley – Care Management Programs
Beth Fiskars – High Risk Care Management
Jill Frey – Data Coordinator
Sam Fell – Manager
General
General Phone: (269)

10. Lakeland Benefits 2018 Co-pay remains $30
Deductible $750, $1,500, $2,250
HSA - $1,500, $3,000
Rx: 4 tier, copay based on % of cost
Rx applies to out of pocket max
Extended network – Complete Out of Network form
Almost everything is the same: co-pay, deductible
Rx – no maxi copay but applies to out of pocket max
Out of pocket – stays the same -In-network: Individual: $4,000, Two persons: $8,000, Family: $8,500
HSA -
Extended network - If you need to have medical services that cannot be done through the Lakeland Care Network, a referral is required. 

11. myHealth Chronic Disease: Public Health Challenge of the 21st Century
Outcome based, health contingent wellness program
Focus: Obesity, Diabetes, CV disease
Biometrics due
We are committed to helping Lakeland associates achieve their best health possible
identify those with modifiable risk factors, encourage effective medical interventions for those with risk factors for disease or already diagnosed with chronic disease and as well as provide worksite based health programs. We know that approximately 65% of disease is preventable, so we focus on interventional interactions that increase health awareness and motivate and support people to make healthy changes in their lives.

12. myWeigh to Health Holistic approach to weight management
Nutrition
Fitness & activity
Self care & Mental health
Weekly meetings

13. Melissa Hahn, RN, Director Leeanne Carlson, Supervisor
Samantha Schultz, Coordinator
Shelli Meulemans, RD
Samantha Schewe, CSCS
Whitney Schueneman, RD
Phone:

14. Michigan Insurance Exchange
Open Enrollment – Nov. 1 to Dec. 15, 2017
Website -
3 Exchange Options: Meridian Choice, Priority, & BCBS
Independent Agents
Exchange navigators/patient financial advocates team:
    or toll-free 

15. Medicare – Patient Enrollment Info.
Open enrollment for Advantage Plans: Oct. 15 to Dec. 7
Open enrollment for Traditional Medicare: 3 months before, the month of, and 3 months after your 65th b-day
Medicare Supplement:
Guaranteed issue with rate lock

16. Lakeland Care Operations
List of contracted payors
Window clings for your practice
Notification of changes
Update requests
News
Search for providers
Print a directory
Contracted payor list
Provider portal links
Team contacts