Partners Health Plan will be celebrating Care Management Week 2023 beginning on Monday, October 9 through Friday, October 13.

Each year, we recognize this week to acknowledge and thank our Care Management employees for the important work they do each day in support of members and their families.

If you would like to thank or recognize a particular Care Manager, we invite you to submit an appreciation message by clicking on the button below. Your message will be shared directly with Care Management staff and help celebrate this important week.

Attention Providers who Prescribe Enteral Supplies or Support Members in Need of Enteral Supplies

We would like to provide an industry update as a follow-up to our Winter 2023 Provider Newsletter article concerning nationwide shortages of enteral nutrition supplies. Unfortunately, this shortage is continuing to occur at the manufacturer level..

The largest manufacturers of enteral products (Nestle and Abbott) have advised that shortages may continue through the end of 2023 and into 2024..

We have been monitoring the ongoing shortage and would like to share recommendations on how to manage enteral nutrition needs of the individuals you support to avoid gaps in service.

• PHP’s DME department would like to remind providers that there are substitute products available from other manufacturers available on the market.
• A new physician order will be required to transition your patients to an alternate product.
• Nestle Alternatives
• Abbott Alternatives

You can reach our DME team by phone at 646-455-1594 and by fax at 646-948-1027.

PHP has an in-house team of DME specialists to assist in ordering Durable Medical Equipment, Prosthetics, Orthotics, and Medical Supplies for PHP Care Complete FIDA-IDD Plan Participants. If a patient you support needs any DME/POS items, please ensure that a complete script and letter of medical necessity (LOMN) is provided to PHP in a timely manner.

Dear Members, Families, and Friends,

Over the last few months, a number of new forms (also known as “variants”) of COVID-19 virus have appeared in communities across the United States. This has been associated with an increase in the number of people getting sick, and hospitalized, due to COVID-19 infection. .

While the total number of cases remains low, in New York State the number of positive tests has increased 400% since June. Experts are sure this is the beginning of a wave of infections that will continue to increase into the Fall and Winter.

We are keeping track of this but want to make sure the IDD community remains safe. People with IDD, as well as the elderly, and those with chronic illnesses such as lung disease, cancer, heart disease and others, are vulnerable to severe illness, increased risk of hospitalization, and other consequences of COVID-19 infections.

Let’s make sure everyone – people with IDD and those that care for, and about them - is protected and can protect each other.

FIRST, with vaccines that are well-proven to prevent severe illness

Please get a flu vaccine as soon as possible.  The flu and COVID-19 can “look and act alike” and getting a flu vaccine will protect you from a known health risk every Fall and Winter. Care Managers can help ensure you get all the vaccines needed to protect your health.

There will be an updated COVID-19 vaccine that will be available in the Fall, one that will offer protection against some of the new variants. Even if you have not received a booster in the past, you should get this version.

Finally, if you or your loved one is over 60 years of age, talk to your primary care provider about getting the new vaccine against RSV, a virus that can cause severe lung disease in older adults. Last year the rate of hospitalizations for RSV among adults was 10X higher than usual. The RSV vaccine can be given at the same time as the flu and COVID-19 vaccines.

If you have any questions about vaccines, please reach out to your healthcare provider.

AND, with physical precautions

Handwashing, physical distancing, and mask usage are all well-established, easy to use and well proven ways to prevent spread of all respiratory infections. 

Masking remains a personal choice. However, healthcare professionals are increasingly considering a return to masking as a precaution in healthcare and residential settings, like hospitals and nursing homes.  Some experts are suggesting that caregivers for those who are at risk should consider using masks as well. Healthcare settings like clinics and hospitals are also reinforcing the importance of workers – including healthcare professionals like nurses and aides - staying home if they are sick.

FINALLY, with early interventions

If you find yourself with ‘flu-like’ symptoms like fever, cough, headache, or muscle pain, get tested as soon as possible. If you test positive, have mild to moderate symptoms and are in a high-risk group, you should ask your doctor or pharmacist for a medication called Paxlovid. Paxlovid can reduce hospitalization rates by 80% if taken within five days of symptom onset.

People who are positive for COVID-19 should stay home or isolate themselves for at least five (5) days. 

We will keep track of the trends and any changes in recommendations for prevention and treatment. 

Thanks for your attention,

Steven Merahn, MD
Medical Director

References:

• Positive Tests Over Time, by Region and County | Department of Health (ny.gov)
• COVID-19 Forecasts: Hospitalizations | CDC
• Americans at high risk advised to wear masks as new Covid variant detected | Coronavirus | The Guardian
• Lessons From the COVID-19 Pandemic: Updating Our Approach to Masking in Health Care Facilities | Annals of Internal Medicine (acpjournals.org)

Dear Provider:

Partners Health Plan (PHP) wants to provide you with an update regarding the ARPA Workforce Stabilization Payment Initiative.

PHP was informed that the State is still working on the requisite details to finalize the provider pass-through amounts and therefore the payments will not be distributed mid-August.   As soon as we receive the updated timing as to when the payments will occur we will send a communication to you. 

Just as a reminder, this installment will include funds associated with the following elements: 

• Retention Payment (including any payments for those now attesting)
• Vaccination Incentive (corrected surveys)
• Longevity Payment (for those who were missing from the initial November installment as well as those now attesting)
• COVID-19 Service (corrected surveys)