Maternity care

Brian Clark:

Good morning everyone and welcome to the first of two webinars for January 2018. Happy new year everyone and welcome back to the webinars series and welcome to all newcomers and thanks for coming back if you were a part of the webinars series in 2017. The title of the webinar today is Maternity Care: Engaging Women with Opioid Abuse and Maximizing Administrative Data Capture for HEDIS Purposes. At the mouthful, I know we're going to be going over a lot and I'll be addressing the agenda topics here shortly. I'd like to introduce myself. First off, my name is Brian Clark and I'm your host. My title is Quality Translator and I work in the quality management department here at Aetna Better Health. Also presenting today we have Aaron [Gooder 00:01:04], she's prevention and wellness coordinator and Debbie Barkley an RN here in the quality management department.

Brian Clark:

The goal of this webinar today and all webinars in this series in 2018 is to spark conversations with providers in multiple States nationwide. Also we're attempting to explore ways to cut down on the burden of medical record review, which is fast approaching in February and still the end of May that project we'll be going on, where the plan will be reaching out for records that were not captured administratively through claims during the measurement year.

Brian Clark:

So I'd like to welcome Louisiana, Pennsylvania, Florida, Texas, Ohio, Michigan, New Jersey, Kentucky, Maryland, and Florida to the webinar today. The webinar will last approximately 40 to 50 minutes and then we'll have some time for questions at the end. During the webinar we'll be pausing for Q&A as well. Participation is definitely encouraged. Please utilize the Q&A box. Now how you do that, you hover your mouse over the top part of the middle of your screen and find the option for Q&A. Choose to participate dropdown option and then type your question or comment in the white box and send to all panelists.

Brian Clark:

What you're looking at here is the Aetna values wheel. Aetna's vision statement or philosophy as the way we manage healthcare is you don't join us, we join you. Now by joining you all on the line today in this webinar environment, it's our hope that we're more effectively reaching our Aetna Better Health members. Now here on the screen, once again, you'll see the Aetna values wheel. Now at the center of all that we do at Aetna are the people that we serve, meaning our providers and our members. Surrounding the center of the values wheel are our four core values: integrity, excellence, inspiration and caring. As a company we act integrity and aspire each day to excel and build a healthier world.

Brian Clark:

And now I'd like to go over some agenda items. First off, we'll go over the importance of maximizing administrative data capture and how that relates to cutting down on the burden of medical record review while illustrating and highlighting appropriate NCQA codes that can be utilized in the office during the measurement year that will satisfy for the HEDIS measures that we will be addressing today. Why timely maternity care is important will be a topic as well. Aaron will be going over the NCQA codes that capture maternity care for HEDIS purposes. And then we'll highlight the importance of engaging women with opioid abuse. And then Debbie will jump in and talk about some additional HEDIS measures that can be addressed, not just at the OBGYN offices but at PCP offices as well. And then we'll go over a hypothetical case story involving hypothetical Aetna members and we'll look at how HEDIS is addressed at the office.

Brian Clark:

So first off, I'd like to just highlight why it's important to attend these webinars. During 2018, we'll be educating on HEDIS measures of care for a certain population of members. It just so happens since that we're focusing primarily on maternity care, but also you'll see that we are going to be highlighting five additional measures that affect women and you'll see how HEDIS is also interrelated to gaps in care and your office functions.

Brian Clark:

Also, during this year, we'd like to illustrate care concerns of Medicaid members throughout the lifecycle, not just Medicaid members, we do have some providers on the line that see members who are dual eligible, meaning Medicare and Medicaid. Just want to let you know that we're also focusing on duals. And then during the series we'll talk about how important it is to get to know the member, their cultural and linguistic backgrounds and how that all relates to continuity and frequency of followup care and preventative care.

Brian Clark:

The third reason why you should attend this webinar series is we have a lot of opinions and comments that will be coming in from varying providers and individuals from different states in the Q&A box. We'll be sharing those comments and questions and addressing questions that are posed during the webinars series. In doing so, we will be exploring ways to cut down on the burden of medical record review. How do you get members in for care? How do you get them in for follow up care? How do you sort appropriately in the office? Do you find that EHR is the best way paper? Et cetera. Those are just some possible questions and comments that we could address.

Brian Clark:

The fourth reason why do you attend the webinar series is you'll get it to know the presenters here in the quality management department quite well and we'd like to see start conversation with you in your state.

Brian Clark:

Another reason why you should attend this webinar series is that you can establish a relationship with an individual in your state, someone who works for your specific plan at Aetna Better Health of Louisiana or Michigan or Ohio or Pennsylvania. There's a specific person and I'll be providing you with their email that you can always reach out to if you have any questions or comments that we didn't get to during the webinar. If you want to learn how to access your organizations gaps and care reports, you can work with your point of contact to get a report run for you. Let's say you want a report that shows all of your well visit gaps. Who do I need to get in for care for well visits or my diabetes population who's due for an A1C test, who needs to come in for a necropsy treatment or a blood pressure check or an eye exam, you can work with your point of contact to close gaps in care. So I'll introduce you all to your point of contact at the end of this presentation.

Brian Clark:

How do you access your point of contact? If you're a little anxious and you'd like to know who that person is right now, type your question or your comment saying, Hey, I'd like to know who my point of contact is. I have a question right now I'd like to email them about it. Someone will be in contact with you within 24 hours. And just as an FYI, about 20 minutes prior to the webinar today, I sent out a copy of these slides to all individuals that registered for the webinar. So you can follow along with us.

Brian Clark:

Before I pass the ball off to Aaron, I would like to just introduce the topic of HEDIS to everyone as a refresher. I'm sure most of you are aware of HEDIS but let's have a little refresher. So HEDIS stands for Healthcare Effectiveness Data and Information Set. HEDIS 2018, that's the current measurement year that we are in right now being that it's January 2018. We are collecting data for care that's given primarily in 2017. HEDIS is developed and maintained by the National Committee for Quality Assurance and it's a standardized way for health plans to document health care services provided to members and it's collected two ways. The ideal way is to capture care administratively through claims, but the other way is through medical record review or data collection. But claims are the fastest and easiest way to collect HEDIS data and correct coding is very important. During this series we will be highlighting the correct codes seeking capture care administratively.

Brian Clark:

Who uses HEDIS data? The public might use HEDIS ratings when choosing a health plan. Regulatory bodies uses HEDIS data for accreditation purposes or enrollment purposes and often if there is a provider pay for quality program in your state, HEDIS scores are linked to your pay for quality program outcomes.

Brian Clark:

I'd like to the pause right now for any questions or comments that might be coming in to the Q&A box and we'll be working with Madison here in quality management to address any questions or comments that are coming into the Q&A box. Madison, do we have anything in there right now?

Madison:

Hi Brian. We did just have a few questions requesting slides after the webinar if they had not already received them. We did also have a question if the recording of the webinar would be available for participants.

Brian Clark:

Yeah, it will. In the future, all recordings of this webinar series will be available on the Aetna Better Health website in your state, under the providers section under News and Announcements. And then additionally, within that section will be a flyer that outlines the entire years schedule. So when will be presenting certain webinars by month, you can look online to find out when the next webinar will be as well as the recording. Yeah. We will be posting the recordings online.

Madison:

Other than that, that's all we had for right now.

Brian Clark:

All right. Okay. I'd like to introduce Aaron Gooder, prevention and wellness coordinator here in the quality management department and she will take the ball from here. Aaron.

Aaron Gooder:

Thanks Brian. I'm going to go over to the maternity care. So first what we're going to start off with, is why sometime timely maternity care is important. Maternity care is really important to all of our pregnant members. Prenatal visits are really essential to make sure that they have the healthiest and happiest pregnancy that they can. Prenatal visits can include things like a physical exam, weight checks, blood pressure checks, blood tests, and as well as lifestyle counseling. This would include things like exposure to environmental tobacco smoke, whether they themselves are a smoker, alcohol use, drug use, domestic violence, things like that. It's really important to screen for all those things during prenatal visits. We consider smoking screenings, also depression screenings and a maternal risk assessment.

Aaron Gooder:

So getting early and regular prenatal care can prevent complications and can help the women take important steps to ensure that they have a healthy pregnancy. Regular prenatal care can also help women control any existing conditions that they may have, such as high blood pressure, diabetes. And it's also important to be able to avoid serious complications, things such as preeclampsia.

Aaron Gooder:

And it's also important that pregnant women complete all the recommended prenatal visits throughout their entire pregnancy, as well as getting the postpartum visit after delivery. It's really important to get them back after they deliver for the postpartum visit, just to make sure that everything is going well and there's no complications.

Aaron Gooder:

We're going to go over three maternity HEDIS measures. There are three stem measures that fall into the maternity umbrella and that's frequency of prenatal care, also referred to as FPC, timeliness of prenatal care and postpartum care.

Aaron Gooder:

The first is frequency of prenatal care. What this measure looks at is the percentage of deliveries of live birth between November 6th, 2016 and November 5th, 2017 that had the following number of the expected prenatal visits, and you can see some ranges there. So the goal for this particular measure is to make sure that numbers get 81% or more of their expected prenatal visits, and that's based on their enrollment date with the plan and their delivery date. So it's really important to make sure that they get in for every single prenatal visit that they should have.

Aaron Gooder:

Another thing to note with these maternity measures is the timeline. You can see that's a little different from other HEDIS measures and that it doesn't fall on the calendar year. It goes from November to November. So for HEDIS 2017, it was looking back at deliveries through November 6th, 2016 through November 5th, 2017 so for this upcoming year for HEDIS 2019 we'll be looking at 2018 data. So that timeline is going to be a little bit different. It's actually going to go back to November 6th, 2017 and go through November 6th, 2018. Just keep that in mind at the timeline's a little bit different for this measure.

Aaron Gooder:

Next is the two stem measures for PPC, which is Prenatal and Postpartum Care. And again it follows along that same timeline of November 6th to November 5th of whatever the measurement year would be. So again, for this year's HEDIS it's going to be looking back at November 6th, 2017 through November 5th, 2018. So this looks at for timeliness, the percentage of deliveries that receives a prenatal visit within the first trimester or within 42 days of enrollment with the plan, but it's really important that members get in and get that initial prenatal visit.

Aaron Gooder:

And the second is postpartum care. And this looks at the percentage of deliveries within that timeline that completed a postpartum visit on or between 21 to 56 days after delivery. The really important thing with postpartum care is that it must occur within that date range, 21 to 56 days after delivery. It has to be in between there in order to account for HEDIS and also it has to be a full postpartum visit. It cannot be an incision check. If it is just an incision check, that will not count. So keep that in mind when dealing with postpartum visit.

Aaron Gooder:

Then you can see here some codes that are commonly used for maternity. Again, the simplest way of capturing prenatal visits is through the standalone prenatal code. It can be captured through a combination of some of the latter codes that are on there, but that must be accompanied by a pregnancy related diagnosis. So again, if you're using a code from the prenatal visits, it has to be combined with that pregnancy related diagnosis code.

Aaron Gooder:

Today we're going to go over a little with the Neonatal Abstinence Program. And this is an order to engage women that have opioid use disorder. So the NAS program, NAS, stands for Neonatal Abstinence. Statement, it's important to engage pregnant women who have significant opiate use and or abuse and prenatal care management. This would include any members that are also on replacement therapy like methadone, suboxone, all that kind of stuff. So it's really important to get these members engaged to prenatal care because they sometimes have high risk pregnancies, some are usually considered high risk and they have maybe some other issues going on that they need addressed.

Aaron Gooder:

So NAS is a group of problems that occur in a newborn who was exposed to addictive opiate drugs while in the mother's womb and also has withdrawal symptoms after birth. Care management will reach out to the mother to offer their services. And this includes things like prenatal care coordination and often remain involved after delivery and will help with the discharge planning and as well as any parent or guardian training during the hospital stay to make sure that they're well equipped to take care of anything whenever the baby goes home.

Aaron Gooder:

So the mother and baby are followed for the first year of the child's life to support the mother's drug and alcohol treatment needs. Ensure the child receives regular well child care and to avoid any preventable health issues and hospitalizations. So it's important that they also be followed throughout to make sure the mom's receiving any possible resources and support that she needs. Things like, again, with her drug and alcohol treatment needs, any kind of other community resources that may need to become involved, and to make sure that the newborn is getting all their well care checks and that they have everything that they need as well.

Aaron Gooder:

So for pay for quality programs, to see if the state that you practice in has any kind of an offering for pay for quality programs and to learn more about it if they do have one available, you would need to reach out to your single point of contact for your state.

Aaron Gooder:

So at this point I'm going to ask if there's any questions in the Q&A box and if you've got anything that I went over with maternity.

Madison:

There's no questions regarding maternity at this time.

Aaron Gooder:

That's great. Thank you Madison. I think at this point I am turning it over to Debbie.

Debbie Barkley:

Thanks Aaron. We'll move right along to the next slide. So in this segment everyone we're going to discuss meeting HEDIS standards of care. While most of the measures are satisfied by care that's given at the primary care by the primary care provider, data can also be captured from other providers such as the OBGYN.

Debbie Barkley:

So let's go over some additional HEDIS terms. Brian went over some terms earlier and we're going to discuss now administrative data. Administrative data refers to healthcare information captured by means other than the medical record such as claims, immunization data, banks and historical encounters.

Debbie Barkley:

Next, let's talk about hybrid review. Hybrid review is when administrative data and medical record review are used to satisfy HEDIS guidelines. There may be a few reasons why hybrid review is performed. Two reasons are measure guidelines require data verification directly from the medical record. That's what the NCQA requirement is or claims coding or other administrative data provided did not completely satisfy the HEDIS requirements to show the care was provided. These are reasons why hybrid review would be performed.

Debbie Barkley:

Another term is hit. This is when the administrative data and the medical record review meet all of the requirements of HEDIS for a measure.

Debbie Barkley:

Exclusion. Exclusion is when the NCQA guidelines indicate that a member must be omitted from a HEDIS measure. An optional exclusion, however, is when a health plan may choose to omit a member from the measure in accordance with the NCQA guidelines.

Debbie Barkley:

Here are the measures that can be addressed by the OBGYN as well as the PCP. The first measure that we're going to take a look at, is Cervical Cancer Screening, CCS, Chlamydia Screening, CHL, Adolescent Well-Care, AWC, Weight Assessment and Counseling for physical activity, WCC, Adult BMI Assessment, ABA.

Debbie Barkley:

And just to let you know, during this segment, we will show examples of NCQA accepted coding for each measure. Now, for a complete or for complete information about the HEDIS measures and all of the approved NCQA codes, you can visit NCQA.org or you can reach out to the point of contact for your state. They can also help you with items such as Gaps in care lists and with other HEDIS reference documents.

Debbie Barkley:

So let's take a look at the first measure and that's Cervical Cancer Screening, CCS. CCS measures the percentage of women 21 through 64 years of age who were screened for cervical cancer using the following criteria. Women aged 21-64 who had cervical cytology performed every three years. Women age 30 to 64 who had cervical cytology and human papillomavirus co-testing performed every five years.

Debbie Barkley:

Now, co-testing versus reflex testing is important. The HPV tests things must be a part of the initial testing order versus being added by the pathologist or by the ordering physician based on the results of the pathological findings. So that's really important to remember. We're looking for co-testing, the measure requires co-testing versus reflex testing.

Debbie Barkley:

Data for this measure can be collected using administrative or hybrid information. Clients may choose to use an optional exclusion for some members if a documentation or coding shows a complete or total or radical abdominal or vaginal hysterectomy with no residual cervix, that is the important part, that there is no residual cervix or documentation or coding can show cervical agenesis or acquired absence of cervix anytime during the member's history through December 31st of the measurement year. So that's important to remember that you can submit coding or documentation of that information for the member to be possibly excluded from the measure.

Debbie Barkley:

Now here are a few codes, CPT codes and HCPCS codes for cervical cytology and HPV testing. Most of the codes are submitted by the lab that's performing the test. And also shown are CPT and ICD-10 codes that demonstrate absence of cervix.

Debbie Barkley:

Let's talk about the next measure, which is Chlamydia screening in women. This measure looks at the percentage of women, 16 to 24 years of age who were identified as sexually active and who had at least one test for chlamydia during the measurement year. This measure uses administrative data only. So that's what's going to be captured through coding.

Debbie Barkley:

Most of the codes that are going to be submitted for this measure are going to be performed by the lab. So you see some coding here.

Debbie Barkley:

Now here is a measure usually captured from data provided by the PCP, OBGYN providers have also provide and codes for this care also. Here we are talking about Adolescent Well-Care. So it's looking at the percentage of members, enrolled members that are aged 12 to 21, especially that age group around the age or slightly before the age of 21 would be captured in an OBGYN office. 12 to 21 years of age as of December 31st of the measurement year, who had at least one comprehensive WellCare visit with a PCP or an OBGYN practitioner during that year.

Debbie Barkley:

Documentation must include a note indicating a visit to a PCP or OBGYN, the date when the well child visit occurred and evidence of all of the following. And if documentation is shown for this as well as codes for WellCare sent in, the documentation that would be needed would be a health history, evidence of physical developmental history, evidence of mental development full history, and a physical exam. Also, what must be included would be the health education anticipatory guidance information that would be given at the visit. So just a reminder, Adolescent Well-Care can be captured using administrative or hybrid data.

Debbie Barkley:

Now here are some CPT codes and ICD-10 codes that can be used to indicate WellCare.

Debbie Barkley:

Now, there are two measures that address BMI and weight assessment. So we're going to talk about these two. The first measure is the weight assessment and counseling for children. That's the WCC and it measures the percentage of members 13 to 17 years of age who had an outpatient visit with the PCP or OBGYN, and who had evidence of all three components in the measurement year. The BMI percentile, not just the BMI value for this age group, because they are under the age of ... They fall into the AWC range for age. We're looking for the BMI percentile documentation and counseling for nutrition and also counseling for physical activity. And it can be collected using administrative or hybrid data.

Debbie Barkley:

Here we see the codes that can be used, the ICD-10 codes for BMI percentile, the ICD-10 CPT codes for nutritional counseling and also the ICD-10 and HCPCS codes that can be used for physical activity counseling.

Debbie Barkley:

The next measure that we are going to take a look at is ABA, which stands for Adult BMI Assessment and as you can see from the age indicated here, it takes off or takes up where the WCC drops off. It's the percentage of members 18 to 74 years of age who had an outpatient visit and whose body mass index was documented during the measurement year of 2017, since we're in Q of 2018 right now or in the year prior, which would be in 2016 and this can be collected using administrative data or hybrid data. And there are some optional exclusions for pregnancy for this measure.

Debbie Barkley:

Here are the codes that can be used to capture BMI value and to demonstrate the visit. Here also is a repeat of the BMI percentile code. However, for this particular measure, the ABA, what is needed to satisfy this measure, is the actual BMI value.

Debbie Barkley:

So let's take a hypothetical look of care that can be captured at the OBGYN office or the PCP office.

Debbie Barkley:

Now here's a chance for you to participate. So what we ask you to do now is to please type your answer in this next segment in your chat box. And also if you would address your responses to all panelists go to the dropdown list and click all panelists. So let's get started here.

Debbie Barkley:

So this is Amber's story. So just to remember, the dates are clues and are important in your answer. And you will also use information that Aaron spoke about in the maternity measures, giving your answers here. So it says today is June 1st. Amber, a 24 year old mother of two is in the office today for postpartum visit. She delivered her second child on April 1st. So the question comes, which HEDIS measures can be addressed and coded for. If you would type your answers into the chat box at this time, let's see what kind of responses we get. And Madison if you would just read those off or see what the predominant answers are as those come into the chat box.

Madison:

I believe we are slowly starting to get some answers. We have a couple of answers. There's a for D, so D and C. We have a few answers for D.

Debbie Barkley:

Okay. And the correct answer is D, all of the above. So all of these measures can be coded for and documented for in the medical record. So be Adult BMI, the cervical cancer screening, and the chlamydia screening in women. Now, next question, which HEDIS sub measure will Amber not be adherent for? We have, A, frequency of prenatal care, B, timeliness of prenatal care, C, postpartum care, D, adult BMI assessment. Which one do you think, if you would type your answers into the chat box. Madison, what kind of responses are we getting?

Debbie Barkley:

And we are looking for the HEDIS sub measure that Amber will not be adherent for. Any responses? I saw one pop up there.

Madison:

I apologize. I was on mute. We have a little bit of B here. It seems like C is the most frequent one. I'm seeing a little bit of everything though.

Debbie Barkley:

And that is correct. C, she will not be adherent for, while we are so happy that she got her postpartum visit according to the NCQA guideline, she is out of that timeframe of 56 days. So it is very important to have members come in or schedule their visits a little bit before that cutoff date just in case they need to reschedule. And Aaron mentioned that timeframe when she spoke about postpartum care. So once again, we're very happy that she had her postpartum visit and the provider should definitely code for that postpartum visit. However, she would not be counted adherent for that measure.

Debbie Barkley:

Let's meet Lin. So this is Lin story. The office staff looks at the schedule and see there is a new patient coming in today. She is requesting to start oral contraceptives. It is noted that Lin is 17 years old with English as a very new second language. When Lin arrive for her appointment, she is accompanied by a friend who is fluent in Lin's primary language and in English. So which HEDIS measures does Lin fall into and can be coded for? A, B, C or D? If you would type your answers into the chat box, we'll take a look at that and discuss that a little bit. And what kind of responses are we seeing Madison?

Madison:

So far we have couple. I see a couple of answers for B. I see one for A, the common ones are B that I'm seeing.

Debbie Barkley:

B is the correct response. Sometimes we may think that she might fall into cervical cancer. She is actually below the age for the cervical cancer screening. However, in this visit, a provider could code for Adolescent Well-Care for the weight assessment and counseling for children. We wouldn't do the ABA because she is 17 years old and the cutoff and the starting age for ABA is 18. So this is an instance where documentation of the BMI percentile is very important. That can be submitted through codes and also in the medical record. Also, the committee of screening, she falls into that age group for that.

Debbie Barkley:

And the reason why, Lin, this day falls into these measures, especially the chlamydia, the CHL, is because she is requesting to start on birth control oral contraceptives. And the assumption is since she is starting oral contraceptives that she may be sexually active, we do know that there are reasons why a person would be on oral contraceptive or any other contraceptive while they are not pregnant. However, this is the guideline for this particular measure. And any documentation could be taken in consideration of excluding this member. But right off hand, they would be included into this measure.

Debbie Barkley:

Let's move on to the next part of this. How can the language barrier be addressed? So we've got some choices here. If you would type your answer into the chat box. Let's see what kind of responses we get.

Madison:

We are getting a lot of responses for options E. That seems to be the only one I'm seeing.

Debbie Barkley:

That is the correct response. While all the others are absolutely methods to be used and can be used, A, is not the best option. We would prefer not to use her friend as an interpreter because a certified medical interpreter is preferred to ensure that the member gets the correct information as far as her care is concerned. Let's move along. And this concludes our segment. Do we have any questions in the Q&A box?

Madison:

We do have a few questions. I do want to make a note that if we don't get to your questions today or if we do not have the answers, all of your questions are forwarded to your point of contact so they can get back to you on that. We do reply to all of your questions. One question, somebody wanted us to clarify, if you can maybe explain exactly what administrative and hybrid data is.

Debbie Barkley:

Yes, we can talk about that a little bit. Administrative data is healthcare information captured by means other than the medical records. So the claims that are submitted, all of those codes are captured into the system and with those diagnosis codes, those procedure codes that are submitted and also some states have immunization data banks or other information that may be captured from other health plans that the Medicaid member may have been a part of, and some states capture that information and pass it on to their next health plan that they are a part of.

Debbie Barkley:

Also, historical data and supplemental data. Sometimes information can be collected, and if it is approved by the auditor, sometimes information that can be obtained from free events that members may have had care at, can be added to the medical record as long as it is sent to the primary care physician and made a part of the medical record. Sometimes that information can be used. So there's a wide range of administrative data.

Debbie Barkley:

Once again, hybrid review refers to when administrative data and the medical record review, as you know at this time we are about to embark on HEDIS 2018 and various health plans will approach or will be in your offices or request records to satisfy the NSQA requirement that gathers HEDIS information. Sometimes information is needed directly from the medical records. One such measure is a measure like controlling high blood pressure. That is a measure that's absolutely the last blood pressure of the year has to be obtained from the medical record.

Debbie Barkley:

And we mentioned some of these measures in this presentation too, can be satisfied by hybrid reviews. So that is optional, but that usually occurs if the information is not captured through coding. So this is why coding is extremely important to reduce that burden of us requesting records or people coming into the office needing to collect those records to bring them back in. That's the purpose of this webinar or these webinar series is to give you the tools to increase your administrative data, your coding, so that fewer and fewer medical record chases are required to satisfy HEDIS measures. Any other questions?

Madison:

We did have a couple of other questions. Somebody asked who exactly reaches out to members during and after their pregnancy? Is it case management Aetna or do we collaborate with home care agencies? That was a question that we had had. I thought that that is one that might depend specifically what plan they carry.

Debbie Barkley:

Yes. And also there are some general things that happen too in addition to variances by plans by state. One thing that usually happens is it is a collaborative effort to get the member in for care. In addition to the outreach that's done by the provider office, also, care management before the Aetna plans usually are involved in reaching out to the members to get their care done, their postpartum care done. Sometimes the hospital facility may reach out to members to direct them to their OBGYN or primary care for postpartum care. But it is a collaborative effort to get members in. So we do encourage that providers do that hands on outreach. But we do want to reassure you that we are working with you to get that done. Any other questions?

Madison:

We have one last question I'm seeing here and it's regarding high risk patients and on maternity care and if there is a maximum limit to the number of visits provided to the high risk patients and does the frequency the of the prenatal care visit apply to maternal fetal medicine providers for high risk?

Debbie Barkley:

Now, with that being said, that is something that would best be served to be answered by the state point of contact. So we will refer that question to the point of contact to get the best answer for that. We just want to let you know that when you entered your question into the Q&A box, we did capture your email address so we will get that answer back to you.

Madison:

There are quite a few questions that keep popping up. Again, just to reassure everybody that even if we don't discuss the question out loud, all questions are forwarded to your point of contact to get in contact with you about.

Debbie Barkley:

Yes. Thank you. Was there anything that we needed to or could address now?

Madison:

Let me have a look here.

Debbie Barkley:

Okay. And also I think Brian May open up at the end if there are further questions. I'm going to pass the ball to Brian to move ahead and then as you're reading along Madison, there's something that we need to address before we drop off at the end. We can talk about that a little bit.

Madison:

Absolutely. Thank you.

Debbie Barkley:

Thank you.

Brian Clark:

All right, thank you Debbie, and Aaron, thanks for presenting today. I just want to mention two things. The additional goal of this webinar series is to prep for HEDIS season 2019. So by attending these webinars and us educating you on varying topics throughout the year, we can be better prepared and we'll be reducing the burden of medical record review during hybrid review next season. And other thing is that I want to let you know that each month there are two offerings for the webinar series for the topics. And this is offering one for January and offering two will be on Tuesday next week. I just want to let everyone know that the recordings of the webinars will be posted after this second webinar is concluded. And give it a couple of days too, because we need to clean up the recording a little bit so you can have a little bit better clarity in the background and I'll get rid of some noise and stuff like that. So just to let you know about that.

Brian Clark:

Now I'd like to introduce you all to your point of contact in your state and this is the person that you can always reach out to via email if you have any questions or comments. And any question that we didn't get to today during the webinar will be forwarded by me through your point of contact for review and for follow up.

Brian Clark:

So if you are signing in from Florida, your point of contact is Michelle. If you're signing in from Texas, that would be Joanna. In Pennsylvania, your point of contact is Diana. Louisiana, that would be Frank. In Kentucky, that would be Kathy. In Ohio, that would be either Sara or Valerie. In Michigan, that would be Dante. If you're signing in from Illinois, that will be Anya. Maryland, that would be Don. And New Jersey, you can reach out to Sami.

Brian Clark:

We will be also presenting another special webinar this month. We actually presented it twice in the month of December, which focuses on what to expect during medical record review. We'll be presenting that webinar on the 10th and the 17th and invites went out for those two offerings a few days ago. So if you haven't signed up already, please do so. That's a very important webinar to attend.

Brian Clark:

And the next webinar will be on Tuesday next week at 4:00 PM, the reducing the burden of medical record review prep for HEDIS 2018 will be on the 10th. Like I said it's 10, the 17th at 3:30. And then let's just take a look at future webinar offerings. Next month we'll be focusing on HEDIS measures affecting 21 and older males. There will be two offerings, one in the morning and one in the afternoon. You can expect that it will be somewhere around this time, and then in the afternoon, somewhere around 3:30. In March, we'll be focusing on 21 and older females and the HEDIS measures affecting 21 and older females. And then in April we'll be focusing on members with serious emotional disturbance and serious mental illness. And there will be two offerings for all future webinars.

Brian Clark:

So now I think I would like to just take some more questions. The panelists will be on the line till 11:00 AM and you can type your question or comment into the Q&A box if we don't get to your question and address it on the phone today, your point of contact will receive your question or comment for followup purposes. So why don't I just go back to Madison at this point. Do we have anything in the Q&A box that we can address?

Madison:

One question I saw that I wanted to bring up to see if we have the answer to, somebody asks if the patient pass the eight week postpartum, are they still to code the postpartum visit using that code or do they code as a wellness visit using the annual code or conclude the pregnancy record during that visit if they're past that eight weeks mark?

Debbie Barkley:

They should still code for the postpartum visit and any other codes that are applicable. So not just limit it to the postpartum visit, but they should definitely post codes for that postpartum visit, wherein they may not be adherent as far as HEDIS is concerned. It is still important for documentation to show that the member did get postpartum care.

Madison:

We did have a couple of questions about ... Just questions from previous webinars that weren't answered from their point of contact. So those questions, as Brian had stated before, are documented here. We will reach out to you all to get you an answer if you've not received one yet.

Brian Clark:

Yeah, Madison, I'll make sure to generate a report that looks at all questions that recurred during this webinar and if there are any that haven't been addressed yet, I'll make sure to personally reach out to the points of contact. Make sure we get those questions answered ASAP.

Madison:

Thank you, Brian.

Brian Clark:

Yeah, absolutely. Debbie, were you going to say something or was that-

Debbie Barkley:

I thought about saying something, but we've covered it. Thank you so much.

Brian Clark:

Okay. Is there anything else there in the Q&A box right now, Madison?

Madison:

As of now that's all that I'm seeing.

Brian Clark:

Okay. All right. Well if anyone has a question or comment, the Q&A box will be open. The presentation will be open for another six minutes and as this questions come in, we will address them until 11 o'clock. If you all want to get going, you can. Thank you so much for being with us today and I hope you enjoyed the webinar and come back for next month's webinar. If you would like to pass off the invitations to any interested colleague that were unable to attend today's webinar offering, please do so and in the future whenever you receive invites from the quality management center department, the theme here at the webinar, offering theme, please go ahead and register. We'd love to have you back.