To help improve quality scores and patient care, MVP is here to support you in closing gaps in care and avoid negative health outcomes, which can result in readmission, lower patient satisfaction, and increased costs to you and your patients.

  • Men's Health: Hypertension and Heart Disease

    Did you know?

    • 51.9% of men aged 20 and over have hypertension
    • 24.1% of men aged 20 and over have heart disease
    • 13.2% of men aged 18 and over are in fair or poor health

    June is men’s health awareness month, and studies conducted throughout the last two decades have shown that men are less likely (than women) to get routine physical exams and screenings. In fact, most will not go to the doctor unless they feel sick and even then, they often choose a walk-in urgent care facility over a visit to a primary care provider. A study published in June 2021 by the insurance company Aflac found that in the United States, out of 1,000 men (ages 18 years and older) surveyed, 45% had not had an annual wellness visit or checkup in the past 12 months and 60% missed visits for preventive care services such as screenings and vaccines. As primary care providers, you and your staff can directly affect the health and wellness of your male patients, but the first step is getting those Members into the exam room. Some potential strategies to help overcome that first hurdle include:

    • Focus on member priority rather than clinical importance
    • Describe to the member what this visit includes and try to identify what appeals most to him (i.e., risks due to family history, previous injuries, sexual health, physical activities, etc.)
    • Provide a health risk appraisal for the member to complete ahead of the visit so that he has a sense of what to expect
    • Identify barriers such as transportation, time off from work, or lack of childcare and discuss potential solutions to overcome these barriers

    Maintaining annual wellness exams, completing preventive care services, and managing chronic conditions with blood pressure checks, cholesterol screenings, and medication adherence will also help to improve your practice’s quality performance. During well-person exams, it is extremely important to talk about what preventive services are recommended/due based on age and any risk factors that may be due to ethnicity and lifestyle. 

    Counsel and screen for the following at every wellness exam:

    • Diet and exercise
    • High blood pressure
    • Smoking cessation
    • Mental health disorders
    • Substance use disorders
    • HIV and other STI’s
    • Dental health
    • Other lifestyle or age-related concerns

    Review history and order screenings, as needed, for:

    • Colorectal cancer screenings (men aged 45 and over and at average risk may be eligible for Cologuard®)
    • Diabetes screening services for members who are overweight or obese
    • Cholesterol screenings for members at certain ages or have a higher risk for developing high cholesterol

    Review immunization history and schedule for upcoming or catch-up vaccines, recommended by age, including but not limited to: 

    • COVID-19
    • Annual flu shot
    • HPV (catch up to age 45)
    • Tdap/DTaP
    • Pneumococcal 
    • Shingles 


  • Improving Rates of Preventive Dental Care for MMC Adult Members Ages 21-64 Years

    Improving Rates of Preventive Dental Care for MMC Adult Members Ages 21-64 Years

    Program Overview

    Low-income adults suffer a disproportionate share of dental disease and are nearly 40% less likely to have a dental visit in the past 12 months, compared to those with higher incomes. Poor oral health can increase risks for chronic conditions such as diabetes, heart disease, and tooth decay—currently the most common chronic disease in the US. The NYS Department of Health (NYSDOH) recognizes the importance of annual dental visits and good oral health for the Medicaid Managed Care (MMC) population and is the foundation for the NYS PIP Improving Rates of Preventive Dental Care for MMC Adult Members Ages 21-64 Years. To help improve preventive dental care rates among this population, the PIP will focus on three areas:

    1. Annual dental visits (ADV)
    2. Emergency department for non-traumatic dental conditions (NTDC-ED)
    3. Social determinants of health (SDOH)

    MVP identified that in 2019, only 25% of MMC adult members completed an ADV and there were more than 1,700 member visits for NTDC-ED. Between 2019 and 2021, MVP MMC adult membership increased over 60%. However, partial 2021 data indicate similar trends for NTDC-ED and a downward trend for ADV. 

    According to the CDC, in the US, nearly twice as many Black and Mexican American adults have untreated cavities compared to White adults. The CDC also reports that about 40% of adults with low-income or no private health insurance have untreated cavities.

    Dental Care is Primary Care

    Primary care teams can help members understand the importance of oral health in the context of their overall health and reinforce the importance of annual dental visits and preventive care. Additionally, primary care providers and their teams can leverage their skills, resources, and tools to intervene in the oral disease process:

    • Ask about the member’s oral health, risk factors, and symptoms of oral disease
    • Look for signs that indicate oral health risk or active oral disease
    • Identify SDOH or local/regional barriers to dental care
    • Decide on the most appropriate response
    • Offer preventive interventions, referral for treatment, and/or self-care practices

    To align with goals for the NYS PIP, MVP has partnered with Healthplex, facilities, providers, and community partners to reduce NTDC-ED, increase ADVs, and improve member experience, access to appropriate care, and overall member health.


  • Spotlight on Medication Adherence

    Spotlight on Medication Adherence

    Published April 2022

    Medication adherence is a critical aspect for managing chronic conditions such as diabetes and hypertension. Despite its importance, medication nonadherence continues to be a serious problem and a leading driver of poor health outcomes.

    Strategies for Improving Medication Adherence:

    • Ensure open and ongoing communication between you and your patient, with the goal of achieving optimal health outcomes. For example, when ordering the initial prescription, educate the Member on the benefits and potential side effects.
    • Leverage all visits, including annual wellness and sick visits to conduct medication reconciliation. Patients fail to take their medications about 50% of the time. Medication reconciliation creates an opportunity to discuss adherence, stress the risk factors associated with non-adherence, and help improve compliance with instructions.
    • Assess if the Member is eligible for a longer-term supply of their medication. Not only does it mean fewer trips to the pharmacy and possible cost-savings for the Member, but studies have also shown that adherence is 20% higher when the individual has a 90-day supply versus a 30-day.

    There are countless reasons for medication nonadherence, and no easy solutions. The best approach for improving adherence is by working collaboratively with the Member and their pharmacists, specialists, and entire health care team.


  • MVP Supports the Following Services to Help Improve Medication Adherence With Your Patients

    MVP Supports the Following Services to Help Improve Medication Adherence With Your Patients

    Published April 2022

    CVS® Caremark Mail Service Pharmacy

    MVP Members who have prescription drug coverage may be able order up to a 90-day supply of their maintenance medications through this program. To find out if a medication is available from CVS Caremark Mail Service Pharmacy, view MVP Formularies, and the select the appropriate formulary; if a drug or drug class has an asterisk (*) next to it, that drug or all drugs in that class are available through mail service program.

    SimpleDose™ from CVS Pharmacy®

    SimpleDose is a convenient and simple medication management solution for your patients taking multiple medications. Eligible medications are presorted into easy-to-open packets based on dose, date, and time. There is no additional cost to enroll. Free nationwide delivery to the Member’s home or any CVS Pharmacy location is included. SimpleDose™ can only be filled for 30-day supplies. If you have a Member who would like to learn move, visit CVS.com/SimpleDose or call 1-800-753-0596.


  • Medication Therapy Management Program

    Medication Therapy Management Program

    Published April 2022

    Eligible MVP Medicare Advantage Members can speak with an MVP pharmacist privately over the phone to review their medications for safety and check if lower-cost alternatives are available. The Medication Therapy Management Program (MTMP) also helps to ensure that Members understand why they have been prescribed a medication and the importance of taking it exactly as prescribed. To find out if a Member is eligible for MTMP, call MVP at 1-866-942-7754, Monday–Friday, 8:30 am–5 pm Eastern Time.


  • A Woman’s Health Journey

    A Woman’s Health Journey

    Published April 2022

    Whether it’s keeping up with routine screenings or needing specialized diagnosis and treatment, women face complex health decisions at every stage in life.

    Adolescence

    Establishing a strong foundation during early childhood and adolescence will make it easier to help them manage changes, both physical and behavioral, as they grow into adulthood.

    • Starting at birth, girls should see their pediatrician or PCP for routine well-child visits
    • It’s important that girls select a gynecologist and start annual well-woman exams once in their teens
    • HPV is the leading cause of cervical cancer. Adolescent girls should get the HPV vaccine series completed between nine and 13 years old

    Teens andYoung Adult

    Working with younger female patients to develop and maintain healthy habits may help them stay physically and mentally fit as they get older. Implement office procedures to ensure your female patients keep regular checkups, health screenings, and immunizations.

    • One in four young female adults will be diagnosed with an STD. Women who are 16–24 years old and sexually active should have at least one test for chlamydia each year.
    • Cervical cancer can be found with regular pap tests. Women should be screened for cervical cancer every three years starting at age 21
    • Women in reproductive years are recommended to seek contraception and family planning counseling

    Mature Adult

    Promoting self-care becomes especially important during this phase of a woman’s life. Along with the demands of everyday responsibilities, women are going through changes that can raise their risk of high blood pressure, heart disease, and diabetes.

    • Use annual well-care or well-woman visits to discuss stress, depression, anxiety, or other mental health issues
    • Begin scheduling breast and colorectal cancer screenings at age 40 and 45, respectively, unless risk factors indicate for earlier screenings
    • One in four women die from heart disease—talk about health screenings that are age or lifestyle appropriate such as blood pressure readings and hemoglobin A1C testing to help prevent or manage chronic care conditions

    Older Adult

    In addition to chronic conditions like heart disease and diabetes, this is the time to speak with your female patients about good bone health.

    • One in two women will have an osteoporosis-related bone break; 33% of women will be diagnosed with osteoporosis by age 75
    • 46% of older women take five or more prescription drugs. Make sure you know all their medications, and if they’re causing side effects.
    • Work with your older patients on a fall prevention plan including appropriate exercises for balance and strength and hearing and vision checks
    • Starting at age 65, women should complete an osteoporosis screening every two years

    From early childhood to older adulthood, the provider-patient relationship that fosters open-communication and coordination of care increases the likelihood that women will be more involved in their health care, improving overall health outcomes.


  • Back on Track with Annual Wellness Visits (AWV)

    Back on Track with Annual Wellness Visits (AWV)

    Published April 2022

    The world may have changed due to the pandemic, but the importance of annual wellness visits has not. Even prior to COVID-19 people may have justified not seeing their PCP annually with reasons like “I never get sick” or “I don’t have any risk factors”. However, in today’s times, it’s vital that Members recognize that preventive care, including annual wellness visits, is an investment in their health.

    Routine annual visits, regardless of the Member’s state of health, allow the PCP to build a comprehensive picture of the Member’s health risks, goals, and barriers. Implementing an integrated approach with your patients that includes physical, behavioral, and social factors encourages Members to be active players in
    their health care and empowers them to make well-informed decisions appropriate for their own health journey.

    Annual visits also provide a good opportunity to remind your patients of any other services they may need, such as:

    • Are they due for a colorectal cancer screening (COL) and would they be a candidate for home screening such as Cologuard®?
    • Are they due for breast cancer screening (BCS) or a bone mineral density test and can you get that appointment set up before the visit is over to ensure better compliance?
    • Remind them if they need a HbA1c lab testing, kidney health evaluation, or retinal screening
    • Review immunizations they may be due for; identify any that can be given during the wellness visit to ensure better compliance
    • Would they benefit from support services or referrals for healthy living such as weight management, behavioral health treatment, or tobacco cessation?

    Continue to utilize telehealth services when appropriate and make sure that Members keep upcoming appointments with outreach calls or letter reminders. Specify what they need to do or have available at the time of the visit, such as medications, list of other health care providers, blood pressure readings, etc.

    While the last two years have been challenging for everyone it is still crucial that plans and Providers work together now to educate, facilitate, and remind Members why annual wellness visits and preventive care are necessary.


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