[Ohioaap-practicemanagers] CPC kids question (Michael Chamberlin)

[Toni Wells]

Dr.  Chamberlain, 

We participate in Partner's For Kids for our Medicaid Managed Care kids.  We currently accept Caresource, Molina, United Healthcare Community Plan and Buckeye Health.   

I have notice that our numbers have always appeared low on our HEDIS measures.  After much discussion and many review of records,  I have discovered that our the difference is between the number of patients that Medicaid has attributed to us vs the actual number of kids that are really our patients.   I  recently reviewed data from 2021 Q2, and found that approximately 75% of the kids attributed to us had never been seen in our practice.   

It is frustrating!  We are a very small practice (1 physician) and I keep a close eye on all our numbers, so I KNOW we are doing the right thing.  When the reports come out, it is discouraging to see the numbers so low.  

This could be similar to what you are experiencing.  

Hope this may shine some light on the problem. 

Have a great weekend!


Toni Wells
Practice Manager
Certified Child Passenger Safety Tech

Hometown Pediatric Care, LLC
p:740.286.5455
f:740.286.6782
a:504 McCarty Lane, Ste 1
   Jackson, OH 45640
w: hometownpediatric.com 
e: twells at hometownpediatric.com
    





-----Original Message-----
From: Ohioaap-practicemanagers <ohioaap-practicemanagers-bounces at lists.deltaforce.net> On Behalf Of ohioaap-practicemanagers-request at lists.deltaforce.net
Sent: Friday, December 3, 2021 12:00 PM
To: ohioaap-practicemanagers at lists.deltaforce.net
Subject: Ohioaap-practicemanagers Digest, Vol 47, Issue 1

Send Ohioaap-practicemanagers mailing list submissions to
	ohioaap-practicemanagers at lists.deltaforce.net

To subscribe or unsubscribe via the World Wide Web, visit
	https://lists.deltaforce.net/mailman/listinfo/ohioaap-practicemanagers

or, via email, send a message with subject or body 'help' to
	ohioaap-practicemanagers-request at lists.deltaforce.net

You can reach the person managing the list at
	ohioaap-practicemanagers-owner at lists.deltaforce.net

When replying, please edit your Subject line so it is more specific than "Re: Contents of Ohioaap-practicemanagers digest..."


Today's Topics:

   1. CPC kids question (Michael Chamberlin)


----------------------------------------------------------------------

Message: 1
Date: Fri, 3 Dec 2021 09:36:19 -0500
From: Michael Chamberlin <mikechamberlinsoapm at gmail.com>
To: "Ohioaap-practicemanagers at lists.deltaforce.net"
	<ohioaap-practicemanagers at lists.deltaforce.net>
Subject: [Ohioaap-practicemanagers] CPC kids question
Message-ID:
	<CACoKQ8nts_gViePpXSYZx6WzdfX3T-oU6V02YTsNW7NeE-0heA at mail.gmail.com>
Content-Type: text/plain; charset="utf-8"

We have concerns that CPC kids is not accurately measuring our patients who are up to date on vaccines.  For example, CPC kids is saying that 11% of our 2 year olds are meeting the HEDIS measure for appropriate vaccination.
  The only managed Medicaid we participate with is Caresource. When we asked them, their reports are saying that over 70% of our 2 year old patients are meeting this metric.  This is quite a large difference.

Has anyone else seen discrepancies in their CPC kids metrics?  Does anyone know of a contact at CPC kids that we could discuss this with?

Thanks for your help,

Mike

Michael Chamberlin, M.D., FAAP
Pediatric Assoc. of Mt Carmel
4371 Ferguson Dr
Cincinnati, OH  45230
513-752-3650
513-752-3387 (fax)
-------------- next part --------------
An HTML attachment was scrubbed...
URL: <http://lists.deltaforce.net/pipermail/ohioaap-practicemanagers/attachments/20211203/01455e92/attachment-0001.htm>

------------------------------

Subject: Digest Footer

_______________________________________________
Ohioaap-practicemanagers mailing list
Ohioaap-practicemanagers at lists.deltaforce.net
https://lists.deltaforce.net/mailman/listinfo/ohioaap-practicemanagers


------------------------------

End of Ohioaap-practicemanagers Digest, Vol 47, Issue 1
*******************************************************