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A Newsletter for SCFHP's Providers
      Vol. 3, Issue 1 - February 2019 

In This Issue

Online Resources 

Dr. Laurie Nakahira Joins Santa Clara Family Health Plan As Chief Medical Officer 
 
Santa Clara Family Health Plan (SCFHP) announces the appointment of Laurie Nakahira, D.O., as Chief Medical Officer.

With more than 20 years in clinical practice and management, Dr. Nakahira is responsible for ensuring the availability, quality and delivery of health care services to SCFHP members via medical oversight of operations and activities of Utilization Management, Case Management, Quality Improvement, Pharmacy, Long-Term Services and Supports, and Behavioral Health. In addition, she oversees the development and implementation of medical policies in support of organizational objectives, compliance, and operational excellence. 

Before joining SCFHP, Dr. Nakahira served as Medical Director and Chief Medical Officer for Davis Street Community Center, a Federally Qualified Health Clinic in San Leandro, CA. She led clinical operations, including quality improvement, clinical audits, and the integration of medical, dental and behavioral health departments.
 
Prior to her work at Davis Street Community Center, Dr. Nakahira was Medical Director and Interim Chief Medical Officer at Alameda Alliance for Health, where she built a three-year interim strategic plan and developed the case management and disease management department.
 
“I look forward to collaborating with the outstanding team of professionals at Santa Clara Family Health Plan and its wide network of providers and community partners to bring high quality care to the most vulnerable members of our community,” says Dr. Nakahira. “I am committed to ensuring that our members receive the best level of care available.”
 
Dr. Nakahira earned her undergraduate degree from California State University Long Beach and attended medical school at Western University of Health Sciences in Pomona, California. She completed her residency at University of Southern California Medical Center Departments of Internal Medicine and Pediatrics at Los Angeles County. Dr. Nakahira is Board Certified in Internal Medicine and Pediatrics.

HEDIS 2019 Medical Records Retrieval 

In support of Santa Clara Family Health Plan’s (SCFHP) 2019 Healthcare Effectiveness Data and Information Set (HEDIS) Project, SCFHP will be requesting access to our member’s medical records.  HEDIS is an important annual quality improvement project that measures the efficiency of SCFHP and our providers in delivering preventive care.

SCFHP has contracted with Cotiviti Health Technologies to work with SCFHP provider offices to retrieve medical records in a secure and efficient manner. State confidentiality laws [Cal. Civil Code §56.10(c) (4)] and Health Insurance Portability and Accountability Act (HIPAA) regulations allow providers to release patient’s medical information to the patient’s health plan (or the plan’s authorized representative) for the purposes of quality improvement, without the patient’s authorization. All medical records and information submitted to SCFHP will be kept confidential in accordance with federal, state, and HIPAA laws.

SCFHP appreciates your cooperation with this medical record review and will work with you and your staff to minimize disruptions to your operations or patient care.

Please email Kiesha Payne at kpayne@scfhp.com or call 408-874-1707 with further questions or for additional information.

CAHPS Reminder 

Medicare managed care plans are required by the Centers for Medicare & Medicaid Services (CMS) to conduct the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey annually. This year, Santa Clara Family Health Plan (SCFHP) has contracted with DSS Research and DataStat to help reach our members and collect our CAHPS results.

Starting in March, the survey will be mailed to 1,600 randomly selected Cal MediConnect members and 3,500 randomly selected Medi-Cal members (both children and adults) and will be available in the CMS approved languages; English, Spanish, Vietnamese, and Chinese. Members will be asked about their perceptions of the quality, timeliness, and availability of care from PCPs, specialists, and pharmacies. The results will be used to determine quality outcomes for both SCFHP and our providers. If your patients ask about this survey, please encourage them to complete it and return the survey before May 31, 2019 in the pre-paid postage envelope provided with the survey. 
 
We hope our members reward SCFHP and our providers with the highest possible ratings. Thank you for helping SCFHP provide the best quality of care to our members.

Target BPTM Program: A Resource for Managing Healthy Blood Pressure  

As a healthcare provider, you play a critical role in managing your patient’s hypertension. The American Heart Association and the American Medical Association developed Target: BPTM, a national initiative that supports physicians and care teams by offering access to the latest guidelines, clinical tools, and support to reach and sustain blood pressure goal rates within the patient populations they serve.

The BP Improvement Program outlines a practical, evidence-based approach to improving BP control for your patients by focusing equally on three critical areas:
  1. Measuring blood pressure accurately and often. Accurate measurement and recording of BP is essential to categorize level of BP, ascertain BP-related CVD risk, and guide management of high BP.
  2. Taking rapid action to address high blood pressure readings.
  3. Partnering with patients to enable ongoing self-management.
Visit the Target BPTM website to take a quick assessment of your practice and learn where you’re doing well and where there are opportunities to improve. 

Additional resources:
SCFHP Adopted Clinical and Preventative Guidelines
Hypertension Clinical Guidelines

Upcoming Continued Medical Education Program 

Santa Clara Family Health Plan (SCFHP) is hosting a free Continued Medical Education (CME) Program on March 5, 2019. This program is based on recent state changes that allow behavioral health treatment for children under 21 years of age without an autism diagnosis.
March 05, 2019 
6:00 PM Registration
6:30 - 8:30 Dinner & Presentation 
Fiorillo’s Restaurant
638 El Camino Real
Santa Clara, CA 95050
Who Should Attend: Physicians, Nurse Practitioners, Medical Assistants, RNs, RDs, and Pediatric Health Care Professionals
Register Now

The presentation, Neurodevelopmental Disorders and Behavioral Health Treatment, will be presented by keynote speakers Manmeet K. Rattu, Psy.D and Jesse Lam, Psy.D. The American Academy of Family Physicians has approved this live activity and participating physicians will receive 2.00 prescribed credits.

If you are interested in attending, please fax the completed registration form to
(408) 362-9817 or contact Claudia Graciano by phone at (408)874-1754. The registration deadline has been extended to February 27, 2019. We look forward to seeing you there!

Request SCFHP Member Resources 

Santa Clara Family Health Plan (SCFHP) member resource flyers and brochures are now available for provider offices. These materials help educate patients about SCFHP health coverage options and when to call the Nurse Advice Line. Providers can request the following materials for their offices by emailing providerservices@scfhp.com. Be sure to include the name of the material, the quantity, language, and an address for delivery.

Avaliable Material: 
  • Nurse Advice Line Flyer 
  • Cal MediConnect (Medicare-Medicaid Plan) Marketing Material
  • Health Education Flyer
Informational Brochures: 
  • SCFHP Overview
  • Healthy Kids HMO
  • Medi-Cal
  • Cal MediConnect

Memo Round Up 

Santa Clara Family Health Plan (SCFHP) is dedicated to keeping our providers informed about operational or regulatory changes. Below are important memos that were sent this past quarter: 
Provider Memo Archive

SCFHP by the Numbers 

Santa Clara Family Health Plan Members (As of January 2019)
Medi-Cal 239,998
Cal MediConnect 7,750
Healthy Kids HMO 3,252
Total 251,000


Santa Clara Family Health Plan Providers (As of January 2019)
Primary Care Providers Medi-Cal Healthy Kids HMO Cal MediConnect
Total 809 789 562
 
Specialists Medi-Cal Healthy Kids HMO Cal MediConnect
Total 4,439 4,416 2,557
 
Ancillary Providers Medi-Cal Healthy Kids HMO Cal MediConnect
Total 619 633 266

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