Community Plan. Missouri Winter practicematters. For More Information

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1 Community Plan Missouri Winter 2018 practicematters For More Information Call our Provider Services Center a t Visit UHCCommunityPlan.com

2 In This Issue... HPV and Oral Cancer Treating Dental Caries with Sealants Influenza Season Highlights The Importance of CAHPS Surveys Expanded Coverage Area for Dual Special Needs Plan New ECHO Programs Starting We hope you enjoy the winter edition of Practice Matters. In this issue, you can read about the transition of flu vaccine recommendations, member surveys, the importance of oral cancer prevention and much more. p.1 Practice Matters: MO Winter 2018 Provider Services Center:

3 Although the ADA states that those with HPV-positive cancers have a lower risk of dying or having recurrence than those with HPV-negative cancers, early diagnosis is associated with the best outcomes: Regular dental check-ups should include an examination of the entire head and neck. These examinations are usually accomplished through palpation and visual examination. Adjunctive testing such as light contrast screening and brush biopsy can also be used to supplement visual examination. Suspected lesions should be referred for a surgical biopsy. HPV and Oral Cancer According to the American Dental Association (ADA), cancers of the oral cavity and oropharynx account for 2.9 percent of cancers diagnosed and 1.6 percent of cancer deaths. The five year relative survival rate for those with localized disease at diagnosis is 83 percent, compared with only 36 percent in patients whose cancer has metastasized. Current studies also point to a statistically significant increase of 2.7 percent in the annual incidence of cancer of the tonsil and 1.6 percent for oropharynx cancer. High risk groups include older males, tobacco and alcohol users, and those exposed to high levels of ultra-violet light. More recently, oral and oropharyngeal cancers are increasingly seen in patients who are younger and female. This is thought to be related to human papilloma virus (HPV). Early Diagnosis and Prevention The ADA notes that HPV, the most common sexually transmitted disease in the United States, is now associated with 9,000 cases of head and neck cancers each year in the United States. It is four times more common in men than women. HPV-positive head and neck cancers typically develop in the throat at the back of the tongue and near or in the folds of the tonsils, which makes them difficult to detect. HPV prevention can include vaccination. The CDC currently recommends that boys and girls between 11 and 12 years get two doses of HPV vaccine to prevent cervical and other genital cancers. It s possible the HPV vaccine might also prevent head and neck cancers, since the vaccine prevents an initial infection with HPV types that can cause head and neck cancers. What We re Asking of You As a dentist or other care provider, you can play an important role in talking with families about oral cancer and the potential risks from HPV. Please encourage families to consider the benefits from vaccination. By working together, we can help protect the future health of vulnerable children, possibly reducing the risk for these cancers. Treating Dental Caries with Sealants After years of decline, the incidence of dental caries has begun to increase, particularly among very young and underserved children. Former Surgeon General Dr. David Satcher, in his Report on Oral Health in America, notes that Indeed, what amounts to a silent epidemic of dental and oral diseases is affecting some population groups. Sealants are extremely effective in the long-term reduction of pit and fissure caries, such as decay on Continued on next page > 3

4 < Continued from previous page the chewing surfaces of teeth. Studies show sealants to reduce the incidence of caries by as much as 50 percent. The American Dental Association (ADA) notes that Pitand-fissure sealants are underused, particularly among those at high risk of experiencing caries; that population includes children in lower income and certain racial and ethnic groups. Sealant Recommendations Sealants are most effective for patients at high or moderate risk of developing carious lesions. Those at low risk will see more limited benefit. Because treatment recommendations are increasingly tied to risk, risk assessments should be included in most patients evaluations and will likely need to continue as risk factors can change over time. Using resin-based sealants on the permanent molars of children and adolescents can reduce caries. There is consistent evidence that using sealants on first and second permanent molars in children and adolescents can reduce the need for future restorative services. Evidence from Medicaid claims data for children who were continuously enrolled for four years indicates that sealed permanent molars are less likely to receive restorative treatment. Restorations were less extensive than in children whose permanent molars that were unsealed. Please consider using sealants in children and adolescents on any pit and fissure permanent first and second molar teeth if the patient or tooth surface is at moderate or high risk for caries. We encourage you to talk with your patients and their caregivers about sealants and encourage pediatric patients to visit their dentist for evaluation Influenza Season Highlights Annual influenza vaccine is recommended for every patient 6 months and older. Advisory Committee on Immunization Practices (ACIP) reintroduced LAIV4as an option for the influenza season. The American Academy of Pediatrics (AAP) recommends an IIV (IIV3 or IIV4) as the primary choice for all children. The effectiveness of LAIV4 was inferior against influenza A (/H1N1) during past seasons and is unknown against influenza A (/H1N1) for this upcoming season. LAIV4 may be used for children who would not otherwise receive an influenza vaccine, when those children are age appropriate and healthy, without any underlying chronic medical condition. All children with egg allergy of any severity can receive either an IIV or LAIV, without any additional precautions beyond those recommended for any vaccine. Pregnant women may receive an IIV at any time during pregnancy. Postpartum women who did not receive the vaccine during pregnancy should be encouraged to receive the vaccine before discharge from the hospital. Vaccination is safe during breastfeeding for mothers and their infants. 4

5 The Importance of CAHPS Surveys The Consumer Assessment of Healthcare Providers and Systems (CAHPS) is an annual industry standard survey used to evaluate patients experience with their health care. From February through June, CAHPS surveys are sent to a random sample of health plan members. The survey is managed by the Centers for Medicare & Medicaid Services (CMS). Consumer participation is voluntary. Improving patient satisfaction with health care services has many benefits. Not only does patient satisfaction increase, it can assist in improving compliance with physician care and treatment recommendations to improve health outcomes, such as addressing care opportunities. The CAHPS survey asks patients about their experiences with care providers. Questions address the timeliness of care, physician communication, care coordination and specialist ratings. If you d like to improve your patients experiences with your practice, we recommend the following tips: 1. Make a personal connection. Everyone in your office can help create a great health care experience for your patients. A smile at the front desk or a quick How are you doing? can make a big difference. 2. Fight the flu. Ask patients if they ve gotten their flu vaccine. If they haven t, explain the benefits and work on a plan to help them get vaccinated. 3. Make it easy for patients to get care. Consider extending office hours and providing multiple services during a single visit. Verify their contact information and submit prior authorizations when they re in the office when possible. 4. Pick the right care provider. Help patients get care more quickly by connecting them with the right care provider for their needs at that time, whether it s a doctor, nurse or a physician s assistant. 5. Reduce wait times. Shorten wait times by limiting the number of same-time appointments. Approach a waiting patient every 10 minutes or so to let them know they haven t been forgotten. 6. Be a good host. When a patient arrives, make sure you greet them. If there s a long wait, apologize and explain the reason for the delay. Provide options that may include rescheduling. 7. Get the complete picture. Ask your patients to sign an authorization form so you can get their medical records from other clinics or care providers. Remind them to bring in health care paperwork from other specialists, as well as all medications and over-thecounter drugs. 8. Explain recommended tests and pass along results promptly. Thoroughly explain any recommended tests your patient needs. Let them know when and how you ll share their results. When you discuss results, be sure to flag any follow-up care that s needed. If there are any delays in getting the results, proactively let your patient know. 9. Go the extra mile. Whatever your role, make an extra effort to help every patient get the care and support they need. A patient s experience can be improved when you listen to their questions, provide clear answers and help them with next steps. 5

6 Expanded Coverage Area for Dual Special Needs Plan Starting Jan. 1, 2019, UnitedHealthcare Community Plan will serve even more eligible members in Missouri. Our UnitedHealthcare Dual Complete Dual Special Needs Plan (DSNP), a Medicare Advantage plan, will expand into the following Missouri counties: Andrew Audrain Barry Barton Bates Caldwell Camden Carroll Clinton Cooper Howard Iron McDonald Madison Maries Moniteau Monroe Montgomery Pike St. Clair Vernon UnitedHealthcare Dual Complete will continue to serve our members in these counties: Boone, Buchanan, Callaway, Cass, Christian, Clay, Cole, Crawford, Dade, Dallas, DeKalb, Franklin, Gasconade, Greene, Jackson, Jasper, Jefferson, Johnson, Laclede, Lafayette, Lawrence, Lincoln, Miller, Newton, Osage, Platte, Polk, Ray, St. Charles, St. Francois, St. Louis, St. Louis City, Ste. Genevieve, Stone, Taney, Warren, Washington, Webster and Wright. Plan Eligibility DSNPs are a specialized type of Medicare Advantage Prescription Drug Plan (MAPD) that must follow existing Centers for Medicare & Medicaid Services (CMS) rules. Members must qualify for both Medicare and Medicaid to be eligible for this Medicare Advantage plan. UnitedHealthcare Dual Complete will reimburse claims based on your UnitedHealthcare contractual Medicare Advantage payment appendix. To find out more, visit UHCprovider.com/ MODSNP. You can also check out our 2019 educational series on the Missouri channel of UHC On Air at UHCprovider.com > Menu > Resource Library > UHC On Air. New ECHO Programs Starting ECHO (Extension for Community Healthcare Outcomes) is an educational program that helps care providers learn more about specific conditions. Using videoconferencing technology, specialists share their expertise with area care providers. Biweekly meetings with an interdisciplinary team help care providers gain a deeper understanding of the treatments and options available to their patients. Current ECHO programs address asthma, autism, child psych, chronic pain management, dermatology, healthcare ethics, Hepatitis C, opioid use disorder and HIV. New ECHO programs are starting soon to address High-Risk obstetrics, Neonatal Abstinence Syndrome and other conditions. As strong advocates of the ECHO programs, we encourage you to sign up for these collaborative programs led by your colleagues. There s no cost to participate and free Continuing Medical Education (CME) is available. To join, visit showmeecho.org/register. Thank you. 6

7 Missouri practicematters Practice Matters is a quarterly publication for physicians and other health care professionals and facilities in the UnitedHealthcare network. Doc#: PCA _ UnitedHealth Group, Inc. All Rights Reserved Riverport Drive Maryland Heights, MO 63043