CMO Corner: Lawrence Magras, MD, MBA, FHM, FAAPL

I am pleased to announce the launch of the Pediatric Complex Care Project ECHO® (Extension for Community Healthcare Outcomes) program at Community Health Network of Connecticut, Inc. (CHNCT) which provides educational and case-based learning opportunities for HUSKY Health program primary care providers. . . read more

The program, led by a team of experts from various universities and practices throughout Connecticut, allows us to harness the knowledge and expertise of specialists and extend that knowledge and expertise out to the HUSKY Health provider network. Our multidisciplinary team includes board-certified physicians, registered nurses, and clinical pharmacists.

Developed in 2003 in Albuquerque, New Mexico by Dr. Sanjeev Arora as a way to meet local healthcare needs, the ECHO movement in the United States has grown rapidly. As of June 2019, Project ECHO has locations in 49 states with 441 programs being offered.

The ECHO model™ links primary care practitioners from multiple sites, the spokes, to a specialist team the hub, to manage patients with complex medical needs during virtual clinic sessions. ECHO clinics are similar to grand rounds, combined with mentoring and case presentations. During the clinics, a brief didactic presentation is given followed by primary care providers from multiple sites presenting de-identified complex patient cases with difficult clinical issues to the hub team. Hub specialists and spoke participants help in addressing some of the concerns by serving as mentors and colleagues. Primary care practitioners who participate in the ECHO clinic become part of a learning community, where they develop the skills and receive the support they need to provide complex care to patients in their own communities. ECHO clinics afford providers both an opportunity to confer with specialists and to interact with peers throughout Connecticut.

We hope you will join us at one of our upcoming sessions.

Date Topic Expert Speaker
8/21/2019 Autism Barbara Ziogas, MD, FAAP
10/16/2019 Attention-deficit/hyperactivity Disorder (ADHD) Deepa Limaye, MD
12/18/2019 Adverse Childhood Events (ACEs) Maysa Akbar, PhD, ABPP

Click here to enroll. Once enrolled, you will receive an invitation to register one to two weeks prior to each session.

For more information and to submit case presentations, please visit the ECHO page of the HUSKY Health website.

Over-the-Counter Coverage Reminder

Did you know that certain over-the-counter (OTC) medications are covered by the HUSKY Health program with a valid prescription? Social determinants of health (SDOH) play a major role in health outcomes and economic barriers can pose a problem in obtaining OTC medications that may be crucial for improving the health status of these members. Lowering economic barriers has been shown to increase adherence, which is associated with improved clinical outcomes.1 As many of your HUSKY Health patients may require therapies that are available for purchase OTC, it is important to note that with a valid prescription, OTC treatments such as low-dose aspirin, artificial tears, various topical products including mosquito repellents, and select vitamins, are covered under their HUSKY Health benefits. A list of therapeutic categories that are part of the OTC expanded coverage for HUSKY Health is available here: https://www.ctdssmap.com/CTPortal/Portals/0/StaticContent/Publications/CT_OTC_Expansion_Coverage.pdf.

1 Neiman AB, Ruppar T, Ho M, et al. CDC Grand Rounds: Improving Medication Adherence for Chronic Disease Management — Innovations and Opportunities. MMWR Morb Mortal Wkly Rep 2017;66. DOI: http://dx.doi.org/10.15585/mmwr.mm6645a2

Resources Available for Patients with Hypertension in the Perinatal Population

The HUSKY Health program has resources available to help perinatal HUSKY Health members with hypertension. The rate of hypertensive disorders in pregnant patients has been trending upward for over 20 years and we know this puts members at risk for postpartum hemorrhage, preeclampsia, pulmonary embolism, and other serious conditions1. . . read more

To help ensure your perinatal HUSKY Health patients get the care they need, we provide access to: low-dose aspirin; blood pressure cuffs; and the Healthy Beginnings Program.

Low-Dose Aspirin

The Department of Social Services (DSS) covers and pays for low-dose (81 mg) aspirin for HUSKY Health members who are pregnant. It can be an important piece of a member’s care regimen since aspirin causes vasodilation due to prostaglandin production and that is vital in the management of the disease process. To prescribe low-dose aspirin for your pregnant HUSKY Health patients, just write them a prescription which can be presented to any pharmacy participating in the HUSKY Health program. For additional information regarding clinical practice guidelines for use of low-dose aspirin in pregnancy, we recommend this link.2

Blood Pressure Cuffs

The use of a blood pressure cuff can help to identify potential health complications in pregnancy or just generally. This benefit is not just for pregnant members. Any HUSKY Health member with a diagnosis of hypertension may obtain a blood pressure cuff for self-monitoring. As with the aspirin, all that is needed is a prescription indicating the diagnosis, type of cuff, and the length of time needed (e.g. lifetime). The HUSKY Health member will present this prescription to any pharmacy that carries durable medical equipment (DME). Prior authorization is not required.

The DME benefit covers three different types of blood pressure devices:

A4660 Sphygmomanometer/blood pressure apparatus with cuff and stethoscope

A4663 Blood pressure cuff only

A4670 Automatic blood pressure monitor

The Healthy Beginnings Program

The Healthy Beginnings program is offered from the Intensive Care Management (ICM) department within Community Health Network of Connecticut, Inc. (CHNCT), the medical administrative services organization for DSS’ HUSKY Health program. Healthy Beginnings is a voluntary, member-centered program designed to support pregnant members as they work towards optimal health. When reaching out to these members, ICM nurses are able to ascertain information pertaining to social determinants of health, which may affect their ability to manage hypertension and other chronic health conditions. ICM nurses can also help to ensure there are no barriers to obtaining blood pressure monitoring supplies and medications, such as low-dose aspirin. ICM nurses can also reinforce the provider’s treatment plan and work collaboratively towards a desirable maternal/newborn health outcome.

If you have any questions about the covered benefits mentioned here (low-dose aspirin, blood pressure cuffs) or how our ICM department can work with you, please call us at 1.800.440.5071, x2024, Monday through Friday, from 8:00 am to 6:00 pm.

References:

1 https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pregnancy-complications-data.htm

2 Please Note: While this information is based on the USPSTF recommendations, AHRQ and the United States of Health and Human Services (HHS) cannot endorse or appear to endorse, derivative or excerpted materials, and cannot be held liable for the content or use of adapted materials that are incorporated on other websites.

Annual Well-Visits Reminder

Well-care is a very important part of our benefit plan so that every member has the opportunity to maintain good health. We understand that it is sometimes difficult for our members to get appointments to see their providers for a well-visit. HUSKY Health does not require 365 days to pass between reimbursable well-visits. There is a limit of one reimbursable well-visit per calendar year, but visits may be scheduled earlier than 365 days apart. Similarly, HUSKY Health reimburses for annual eye exams for all members. The allowance for glasses is one pair every two years. Members under age 21 are not subject to these limitations.1

1 https://www.huskyhealthct.org/providers/provider_postings/benefits_grids/Vision_Grid.pdf

Lead Screening Gaps in Care Report Available on the HUSKY Health Secure Provider Portal

The “Gaps in Care: Lead Screening”” report is now available on the secure provider portal! It is a monthly report that details children ages 9 to 24 months who are due for lead screening. . . read more

The HUSKY Health secure provider portal gives you access to a variety of other reports on your patients, such as: gaps in care; admissions and discharges; ED utilization; and much more.

You can view important information for the adult and child patients attributed to you on our secure provider portal.

To access the reports, you must first set up an account on the HUSKY Health secure provider portal by visiting portal.ct.gov/husky, clicking “For Providers,” then “Provider Login.” Once you have an account, you will be able to request access to your reports. You will be notified via email when your report(s) are available for viewing. To learn more about how to gain access to the Provider Portal Reports, click here.