The Fall of Flu and COVID
A Discussion with Daren Wu, MD, Chief Medical Officer at Open Door Family Medical Center
The recent resurgence of COVID outbreaks fueled by variants, combined with the return to the office and school and relaxed preventive protocols, has led many to predict higher volumes of sick patients through the fall and winter. With these factors in mind, we want to understand how Open Door is preparing to handle these potential challenges while caring for their patient’s physical and mental health needs.
Dr. Wu, how are you preparing differently today for the cold and flu season in combination with COVID than you have in previous years?
Throughout the pandemic, we have continued to be flexible and are able to pivot to change our procedures to help our patients with ever changing needs. We have been very successful in utilizing telemedicine as a way of identifying symptoms before a patient would come into our facility. We also have strict check-in procedures that helped us to quickly identify well patients from sick patients, allowing us to separate them into distinct designated areas to mitigate the risk of spreading infections.
How have you been proactively encouraging patients to get the flu vaccine?
Our organizational culture emphasizes wellness and preventive care. As such, we have a long history of broadly encouraging our patients to get vaccinated whenever possible, and that includes against flu.
We continually have conversations with our patients regarding recommended vaccinations, even during medical visits in which they present for something entirely different than an interest in vaccinations. We provide them with education on the important role of vaccinations and are comfortable working and coaching those patients who may be vaccine hesitant. We cannot change everyone’s minds, of course, but we certainly do try!
We are very ready to give lots of flu shots this season, with flu shots from many manufacturers, encompassing all age groups, and even a non-injectable nasal spray formulation, for those who really do not want a shot.
How are you identifying at-risk patients and how are you communicating to them about scheduling their vaccinations?
Even prior to the pandemic, we’ve relied on having robust data-aggregation to identify high risk patients and encouraging them to get the flu shot. The data informs and supports our “flu shot campaigns” that include sending text message reminders to patients. These campaigns had built in mechanisms to not only remind them, but to give them the opportunity to request an appointment right away. When COVID shots became available earlier this year, we used the same mechanisms to identify eligible patient populations, such as older adults and those with high-risk conditions, and we used these processes to great success. To date, this organization has administered more than 45,000 vaccinations against COVID, which is a very large number for an organization our size.
Do you have the capacity to provide COVID vaccine boosters at high volumes once they are available?
Yes, once they are available, we will use the same mechanisms to identify and reach out to high risks patients and book appointments. Due to our capabilities to provide mass vaccinations, we were one of only 25 federal health centers in the country that initially were selected to help with COVID vaccinations, and that was because we have a track record of success when it comes to many clinical processes. During that time, we are administering 2,000 shots per week. We learned a lot from the NYS DOH vaccination sites about how to provide such a large volume of vaccines, including creating an “assembly line” where each individual had a single task and moved patients along quickly with a single point of entry and exit. We were also lucky to have a large number of volunteers at our disposal. We credentialed individuals with Open Door who had professional experience giving shots to patients which has resulted in a group of volunteers ready to assist. Even with flu vaccines and possible COVID booster vaccines, we don’t expect the volume of 2,000 shots per week, but the process remains flexible and scalable, so we’ll be ready for whatever comes.
How are you preparing to provide COVID vaccines to kids under 12?
We are preparing messaging to parents, with scripts in both English and Spanish. We have a strong IT infrastructure, and good data capabilities, so once the vaccines are approved, we can start disseminating the messaging to parents and start vaccinating children the next day.
How have you addressed the mental health of your doctors, office staff, and their families?
We recognize the need to provide the best support possible to our staff, as we are fully aware of a spike in turnover at all levels – Medical Assistants, Dental Assistants, Medical Directors, it has been a serious concern for us, and many practices in our area and across the country. A particular problem is that practices cannot hire as many Behavioral Health Providers as are leaving. All health systems are dealing with this. To stay ahead of it, we have in some cases reduced in-person hours for our clinicians, adjusting schedules 5 days a week to 4. Providers want more flexibility, as the pandemic has put a spotlight on enjoying the time you have. Something we have implemented is to allow providers to work from home virtually. More than 40% of our clinical encounters were in the form of Telehealth during the height of the pandemic and we intend to continue with Telehealth – due to its popularity with both patients and staff, in perpetuity. At this time, with many more patients choosing to come in-person, we still maintain Telehealth at over 20% of our visits, and many of our clinicians are able to continue working one day per week from home This has been a good transformation and an effective way to both provide care for patients and support our staff.
New D-SNP Plan Provider Training
Effective January 1, 2022, MVP will offer a new D-SNP plan for enrolled individuals dually eligible for Medicare and Medicaid in the Capital District (Albany, Columbia, Greene, Rensselaer, Saratoga, and Schenectady counties), and the Hudson Valley (Dutchess, Orange, Putnam, Rockland, Sullivan, Ulster, and Westchester counties). Special Needs Plans (SNPs) are a type of Medicare Advantage (MA) plan designed for individuals with special needs focusing on intensive care coordination.
The Centers for Medicare and Medicaid Services (CMS) require Providers who care for patients in D-SNP plans to complete a training. All Providers in the Medicare network in the counties listed above must complete this training, which will take approximately 15-30 minutes. MVP understands your time is valuable, so as a thank you, we will email all Providers who complete the training by November 30, 2021, a $25 Amazon gift card.
To access the training, visit mvphealthcare.com/DSNPeducation. Once you have taken the training, complete the form below it to verify completion. Upon submission, an email will be sent with instructions for how to claim your gift card.
If you have any questions about this training requirement, please contact your MVP Professional Relations Representative.
MVP to Launch new Pharmacy Electronic Prior Authorization Process in November
In November MVP will launch a new tool to manage electronic prior authorizations (PA) for pharmacy and medical drug claims for Members in all plans*. Providers will be able to access the new tool, powered by Novologix, via a link in their online provider account. Providers may request access to their online account at mvphealthcare.com/ProviderRegister.
Once logged in to their account, providers will be able to initiate a PA, which will run a test claim to determine if a PA is needed. If a PA is required, additional information will be collected, if necessary, and the request will be submitted to an MVP medical director for approval or denial. Providers will now know immediately if a PA is not required, and if it is, they will know within a few minutes to hours if it is approved or denied, instead of potentially waiting days.
Additional information will be sent to providers in October for how to access the new tool and accompanying training documents.
*This new tool will be usable for Members in all plans except ASO plans with pharmacy carved out. Providers will be immediately notified if they submit a request for a member who does not have pharmacy benefits with MVP.