December  2020 |  Vol. 6   No. 6

Deputy Director's Corner

Happy December, everyone!

Each month we will highlight efforts with our Medicaid Transformation initiatives or with our placemat initiatives. All state departments have department placemats, and the divisions within Social Services have their own placemats, too. You can see the department placemat by going to the intranet, and clicking on the Operational Excellence tab. I’d like to highlight intranet feature in each newsletter, too, so while you’re there checking out the placemat, click on the Organizational Health tab and the Improvement and Success tab, as well!

One of the initiatives on our MO HealthNet placemat is under “Improve the Customer Experience”. The project is “Work with Civilla to assist with improving the customer experience.” Civilla is a non-profit design studio and their team worked with DSS team members from FSD and MO HealthNet on a very exciting project getting ready to enter phase two. The goal is to improve the enrollment process for our participants and our employees, both. You can read the press release here https://dss.mo.gov/press/11-10-2020-benefits-transform-report.htm and read the entire report here https://dss.mo.gov/docs/civilla-missouri-research-report.pdf.  Kirk Mathews has been heading this up for MHD. Thanks, Kirk!

Another MHD placemat initiative is under the “Modernize Delivery System” and the project is to Expand Telehealth. We’re going to update that soon to call it Expand Telemedicine, as we’ve chosen to refer to it as Telemedicine. We sent out a provider blast a few months ago, asking our providers to take a survey and let us know how we did, responding to COVID 19, and also to specifically let us know how their experiences had been with telemedicine. Many providers weren’t familiar with it, or with how to bill for it, or what the rules are around it. Many people weren’t sure if they had to have a certain type of computer, or software, or if they could use Zoom, or use a smart phone. Dana Bernier set up a dedicated COVID email account, (thanks, Dana!) and most of questions received had to do with telemedicine. The survey results told us that even though there were some difficulties, like participants didn’t have or understand the technology sometimes, and some providers found it difficult doing a telemedicine visit with a young child, overall the feedback was excellent. Some said “Telehealth is a Godsend!” It allowed providers to stay in touch with patients, counsel them, keeping them healthy, while protecting their office personnel and allowing the patients to stay home.

MHD did such a good job responding to providers and getting information out there, that in a recent CMS publication called “Services Delivered via Telehealth Among Medicaid & CHIP Beneficiaries During COVID-19”, Missouri was the leader in telehealth services to people 19-64 from March through June. We had the highest monthly rate at 520 services per 1,000 participants ages 19-64. Everyone at MHD should feel great about that, knowing our efforts to communicate promptly with providers paid off.

Nanci Nikodym is heading up a Telemedicine working group with a large number of stakeholders to put together a new state regulation around telemedicine that will promote the program while ensuring high quality in the delivery of those services. Thanks, Nanci!

Next  month we will highlight some more of our initiatives.

Did you know? December 10: International Human Rights Day, established by the United Nations in 1948 to commemorate the anniversary of the Universal Declaration of Human Rights.

As we move into December, I am sure many of us will miss all the holiday goodies and the chance to get together for special lunches. This year, we have to stay vigilant and have virtual celebrations. Please plan to do that with your teams! We all need a little team-building right now! You can Google “online office games” for some ideas. Be sure to check in on one another.

"Now faith is the substance of things hoped for, the evidence of things not seen."

Hebrews 11:1

Merry Christmas!

Happy Hanukkah!

Kwanzaa blessings to you and yours!

Jessie

Unit Spotlights

Primary Care Health Home

In January 2012, MO HealthNet began the first statewide Primary Care Health Homes in the nation. This value-based model improves health outcomes for individuals with complex, chronic diseases. Primary care providers perform advanced care management that includes brief behavioral health interventions and coordination of services that minimize social determinants. This team-based care approach identifies and addresses gaps in primary care, but also engages the participants and their caregivers in patient-driven goals that ultimately improve their quality of life. This added care coordination has been vital to our members during this pandemic as primary care teams reach out monthly and sometimes weekly to support those in the program with their physical and emotional needs. The Per Member Per Month payment model also cost-effectively sustained employment of the primary care staff as clinics faced economic challenges in both rural and urban clinics.

The overarching objectives of the Primary Care Health Home Initiative include:

• Reducing avoidable participant hospitalization, readmissions and unnecessary emergency room visits by building a strong, primary care team connection with our MO HealthNet members
• Improve coordination and transitions of care by requiring a rapid 72-hour response to care planning needs post-hospitalization
• Improve clinical indicators (A1C, blood pressure, BMI, LDL, medication adherence, tobacco-usage) by requiring transformation practice training and tracking of patient-specific outcomes on a monthly basis
• Demonstrate cost-effectiveness to support the sustainability of the model

For the 2019 calendar year, the average cost-savings for someone enrolled in the program for 12 months was $134.35 savings per month per member. Part of these savings are attributable to significant health improvements and an overall 35% reduction in ER visits. To learn more on program requirements, qualifying diagnoses, and the substantial improvements in clinical indicators, follow this link to the health homes progress report: https://dss.mo.gov/mhd/cs/health-homes/pdf/pchh-progress-report-2018-2019.pdf or email Jennifer.L.Hunter@dss.mo.gov. 

Combatting Fraud, Waste and Abuse - Pharmacy Unit

According to CMS, in fiscal year 2019 there was an estimated $57.36 billion in improper Medicaid payments throughout the United States, equaling out to an overall 14.9% improper payment rate. Contributors to these potentially improper payments include fraud, waste and abuse activities and impact almost every health care sector, including within the pharmacy program. Writing and filling illegitimate prescriptions, forging or altering prescriptions, rendering inappropriate or unnecessary services, and dispensing excessive medications are all examples of the potential fraud, waste and abuse activities. There can be many definitions and examples of fraud and abuse but here at MO HealthNet, we define them as the following:

• Fraud: an intentional deception or misrepresentation made by a person with the knowledge that the deception could result in some unauthorized benefit to him or herself or some other person. It includes any act that constitutes fraud under applicable Federal and State laws, regulations and policies.
• Abuse: provider, supplier, and entity practices that are inconsistent with sound fiscal, business, or medical practices, and result in an unnecessary cost to the Medicaid program, or in reimbursement for services that are not medically necessary or that fail to meet professionally recognized standards for health care. It also includes participant practices that result in unnecessary costs to the Medicaid program.

With the increasing cost of medications and increases in enrollment, it is imperative that MO HealthNet strives to manage improper payments in every way possible. One such strategy was the creation of the Program Integrity Pharmacist position within the MO HealthNet pharmacy unit. Responsibilities of the Program Integrity Pharmacist include working closely with Missouri Medicaid Audit and Compliance, the Program Integrity Unit and the Medicaid Fraud Control Unit to proactively identify and collect overpayments. This entails developing new fraud, waste and abuse policies and procedures in conjunction with recommending enhancements to current pharmacy edits along with the addition of new edits. This position will also continually conduct analytics accompanied by data mining of validated encounter data to find potential leads in fraud, waste and abuse. Overall, the vision of the Program Integrity Pharmacist is to ensure the appropriate and accurate allocation of taxpayer funds and plays a vital role in the robust MO HealthNet Medicaid program.

DYK...

DYK that our MHD intranet page can be found at https://dssintranet.mo.gov/dss-mhd/?   There are all types of interesting information that can be found including:

• Visit the Holiday Fun page for December!   Keep those pictures comings!
• If you like to cook or bake, visit the Recipe Corner.  Feel free to share your favorite recipe's by sending them to Gail Luecke.

MHD is seeking individuals to form a subcommittee under MHD Connections for team members that have a desire to increase and promote inclusion, diversity and leadership at MO HealthNet. This group of people will meet monthly (1-2 hours a month) to work together to find ways to celebrate diversity, engage in team building experiences and provide education/training opportunities around inclusion, diversity and leadership.  If you would like to be a part of this committee, simply submit your name and unit you work in via email to MHD Connections.   If you don't want to be part of the committee but have suggestions on ways to increase diversity and encourage inclusivity in our workplace, please submit your suggestion, submit those to MHD Suggestions email or  drop in one the suggestion box located in Center Court.

DYK:

• December 1: World AIDS Day  December diversity events include World AIDS Day, which aims to raise both awareness and money to help fight HIV. It began in 1988 to encourage political leaders to keep their commitment to achieving universal access to HIV/AIDs prevention, treatment, care, and support by the year 2010. As of 2012, the multi-year theme for this day of observance is “Getting to Zero,” with a new goal to get new HIV infections to zero. Build inclusion of LGBTQ+ and other diversity groups with online diversity training.

•  December 26 – January 1: Kwanzaa- an annual celebration of Africa-American culture and a tribute to African festivals of harvest. The holiday was created after the Watts Riots in 1966. Its goal was to give Black people an alternative holiday to celebrate themselves and their culture. It celebrates seven different principles of African Heritage, and families will decorate their households with art, eat fresh fruits, and wear cultural pieces.

Staff News

Welcome to MHD

Erica Peart joined MHD as a Benefit Program Specialist in the Constituent Services Unit.   She formerly worked in the Customer Service Center  for FSD. Erica is a busy gal.   She has an Associates Degree now and will graduate in December with a Bachelor's Degree in Human Services AND in February with a minor in Sociology.  She is also the first person in 2 generations in her family to graduate from college.  Erica's hometown in Moberly but currently resides in Ashland with her 2 daughters, ages 6 and 10. Erica hobbies include walking, games with her family and traveling.

Congratulations go out to Cindy Evers who retired on November 30.  Cindy worked for the state of Missouri for 28 years.  She worked 24 of those years with DSS, which included 9 years with MHD's Program Operations Unit. Cindy will surely be greatly missed by her friends and co-workers throughout MHD; however, we are excited for Cindy and her future endeavors.

• Major Kudo's go out to Nikki Graham and Jackie Morrow.   Becky McCarthy said "Nikki and Jackie represented TPL and our Department so well when they helped a participant's family member on an estate recovery case." The family also wrote a note to Nikki saying,  "I can't thank her enough for all the help she provided to my family and me through the difficult time of selling my Grandmother's house."
• Sarah Becker wants to give a SHOUT OUT to Ryan Gesch.  "Thank you so much for all your help with Cognos Ryan!!"
• Congratulations go out to Michelle Kohrmann for being the 1st winner for the Department's Stress Management Challenge. 
• Lynn Thomas  would like to send out Kudos to Jeanette Book.   She said "She brought an amazing idea to our unit to share and enjoy pictures of our families. We had a great time seeing pictures of wrestlers, astronauts, grandkids, newborns, grandkids jumping horses, group photos of grand kids, learners permits being issued and grandchildren being selected for high school basketball. It is the closest I have felt to my unit since we left the building. Even though we have weekly meetings and share it brought a lot of smiles. We are doing it once a week for our break and I am looking forward to all that we will share with each other on Wednesdays. It’s a great way to bring smiles to each of us at the end of the day. We miss seeing each other and this is bringing us back together in a unique way. Kudos to Jeanette."

5 Star MO Learning Classes Fostering Belonging as a Leader.   It's very timey in these remote-work times!

Employment Opportunities

Do you have a friend or family member looking for a career change or job opportunity?   Are you looking for a career development/promotional opportunity?    Visit  MO Careers to view & apply for  current job openings.   Below are a  few positions currently open:

• Senior Accountant ( DFAS) - Closes December 4, 2020.
• Senior Accounts Assistant (DFAS) - Closes December 3, 2020.
• Administrative Manager (DOR) - Closes December 20, 2020
• RN (DHSS) - Closes December 4, 2020
• AOSA (DOC) - Closes December 4, 2020
• Correctional Officers (DOC) - Closes December 14, 2020

MHD  Connection News

It's December and we are fast approaching the end of 2020.   It has been a year we won't soon forget but are probably happy to see it go!

Upcoming Events:  

• We are going to continue showcasing your many decorating talents over the holidays.  Send Gail your pictures and we'll show them off on our Holiday Fun page.

Although we don't have anything currently planned , please feel free to share your ideas with any committee member: Gail Luecke (Chairman),  Nanci Nikodym (Treasurer), Pam Burris, Nici Smith, Karen Pendleton, Stephanie Hunt, Bridgette Hicks, Stacie Gibson, Sheana Wilcox, and Carolyn Twardowski (secretary). 

Staff Forums

We are always looking for idea for staff forums.   If you have a particular subject or idea that would be of interest to you and others, please let us know.   You can email MHD Connection at MHD.Connection@dss.mo.gov

What's Cooking at MHD?

Send me a note if you've tried any of the recipes and what you thought.  Keep those recipes coming and enjoy these delicious treats!!  Here are a couple of those recipes featured on The Recipe Corner.  

MHD Calendar

Visit our Calendar of Events page for WEBEX Meeting Info

12-17  Drug PA Advisory Committee Meeting

12-25  Christmas Holiday Observed

REMINDERS CONFERENCE ROOMS:  Please remove meetings from the conference room calendars if you know that staff will be attending your meeting remotely and you will not need the conference room.   TO THOSE WORKING REMOTELY:  Please ensure you have turned off desk lights, monitors, and other electronic devices not in use.  Also, if you have any plants, please remove them or arrange to have them watered. KEEP YOUR OUTLOOK CALENDARS UPDATED PLEASE!   Since the majority of our staff is now working remotely, PLEASE remember to keep your Outlook calendars updated.   This includes scheduled days offs, meeting, training, regularly scheduled days off due to working a compressed work schedule, etc.   By doing this it will help immensely to ensure meetings are scheduled within your work hours and help staff working deadlines to be able to plan around planned absences or if they need to reach you.  Thank you.