Incontinence Supply Denials
UHA follows Oregon Authority Rules (OAR) 410-122-0630 for incontinence supplies coverage requirements. These can be found at here. UHA may be more strictly adhering to these OARs as part of our contract compliance. In summary, incontinence supply approval requires:
Chiropractic Referral Reminders for PCPs
Initial Evaluations and Submissions
Clinical Advisory Panel adopts new Clinical Practice Guidelines
The Clinical Advisory Panel (CAP), whose members are composed of representatives from the community practices, met in March and approved a number of new Clinical Practice Guidelines (CPGs).
They also endorsed a new tool created by UHA Pharmacists that summarizes these asthma guidelines as well as the GOLD guidelines for COPD in a 1-page format that is aligned with the UHA drug formulary.
These four additions can be accessed on the CPG page: https://www.umpquahealth.com/clinical-practice-guidelines/
Policy updates: CE05-Utilization Review
We have updated a number of policies that are featured on our Provider Trainings page. We have highlighted one below:
Prior authorization requests that require review by a Utilization Review Coordinator are assessed for medical appropriateness and necessity by using the following resources:
Denials must finally be reviewed by a Doctor of Medicine or Pharmacy (for Rx requests).
Also see our other updated policies on our webpage at https://www.umpquahealth.com/provider-trainings/.
Advanced Care Planning Available to All Residents of Douglas County
In February, we announced a specialized service for Advanced Care Planning (ACP) for UHA high acuity members by provider referral. This one on one service facilitated by Iris Healthcare is known as Premier; more information is available under the Provider tab on our website at this link.
We are now excited to announce that UHA offers ACP for all residents of Douglas County, regardless of their insurance status. This service is a web-based platform that asks questions that inform the creation of ACP documents at the conclusion of the digital interview. (Think online income tax preparation.) Since this empowers everyone to communicate their healthcare wishes to share with their family and caregivers, we call this service Empower. Access to this service is available under the Member tab on our website at this link.
We encourage providers to create a link on their website to access the Empower service. For information on how to do this, contact Kat Cooper at firstname.lastname@example.org.
For the latest information on COVID vaccination in Douglas County, visit Douglas Public Health Network: http://douglaspublichealthnetwork.org/
A recent perspective article in NEJM discusses how lessons learned from the Quality-Movement, spearheaded by the IOM, could be applied to Work-force Diversity; specifically: measurement, reporting, and incentives.
“Lack of workforce diversity has detrimental effects on patient outcomes, access to care, and patient trust, as well as on workplace experiences and employee retention. A substantial number of White medical students and residents hold biased views about race-based differences in pain perception that affect their treatment recommendations” … Addressing Workforce Diversity — A Quality-Improvement Framework – Lisa S. Rotenstein, M.D., M.B.A., Joan Y. Reede, M.D., M.P.H., M.B.A., and Anupam B. Jena, M.D., Ph.D. To download full article, click here.
Roseburg Family Medicine Residency (RFMR) program, is a beacon on Workforce Diversity for Oregon
A Town Hall about Traditional/Community Health Workers will be featured via Zoom on April 12 from Noon-1pm. Check your emails for the link!
Community Health Worker Training
This course will help prepare students to serve as a Community Health Worker (CHW).
The course addresses all requirements as outlined by the Oregon Health Authority and upon receiving a passing grade, students will qualify to apply for accreditation as a Community Health Worker to the Oregon Health Authority for the State of Oregon.
Flyer at this link.
Value-based payment webinar series for providers (no-cost CME available)
Primary care, behavioral health, and maternity care providers are invited to a five-part webinar series focused on increasing readiness for VBP and taking advantage of the additional flexibility VBPs offer for innovatively redesigning care models.
Speakers: Art Jones, Jeanene Smith, Janet Meyer (Health Management Associates)
See flier for full details and registration: https://www.oregon.gov/oha/HPA/dsi-tc/Documents/VBP-Webinar-Series-Spring-2021.pdf