January 10, 2017  Vol. 3, No. 1

Misael Guerra Named VP, PCMH Implementation

Achieving PCMH Level 3 Certification by December 31, 2017 – just one year from now – is a requirement for PCPs participating in DSRIP and, moreover, PCMH is fundamental to the transition to value-based payments. To hone our focus on this core strategic project, ACP has appointed Misael Guerra as Vice President of PCMH (Patient-Centered Medical Home) Implementation. Mr. Guerra is responsible for managing this complex, far-reaching project that represents one of ACP's largest budget items. 

PCMH is a model of care that emphasizes care coordination and communication to transform primary care into "what patients want it to be."  As members of the ACP network, PCPs are entitled to the services of a practice transformation specialist – provided at no cost. Mr. Guerra will serve as the liaison between ACP's PCPs and these practice transformation specialists to ensure high-quality service, timeliness, and a sufficient pipeline of PCPs. Although the certification deadline is December 31, 2017, PCPs must begin the process by March 31, 2017.
 
Mr. Guerra joined ACP as a member of the Physician Engagement team with a focus on PCMH. It soon became clear that his skills and experience were closely aligned with ACP's urgent priority around the PCMH initiative.
 
Mr. Guerra earned a B.A. in Sociology from the University of Arizona and an M.A. in Business from Webster University. He holds a Group 1 Health Insurance License as well as FINRA Series 7, 66, and 24. He served as a Commissioned Officer in the U.S. Navy and has extensive experience in sales, training and consulting in financial services and insurance, working directly with medical practices and physicians.

Denisse Oller, Emmy-Award Winning Journalist, Joins ACP 

Denisse Oller, Emmy-award winning television journalist, author, and chef, has joined ACP as Director of Integrated Outreach. In this newly created position, Ms. Oller will develop initiatives to inform, educate, engage, motivate and empower individuals and families about the importance of preventive health care and healthier lifestyle choices. Ms. Oller will serve as a spokesperson for ACP’s ongoing outreach to improve health literacy, with a focus on Latinos, in underserved communities where there is a prevalence of chronic illnesses such as asthma and diabetes.
 
“Denisse Oller is a household name in the Latino communities that we serve,” said Thomas Milligan, Vice President of Communications. “With her credibility, recognition and expertise, Denisse is the ideal person to help ACP increase health literacy and deliver a strong message of wellness and preventive health that begins with a Primary Care Physician.”

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ACP Chairman Dr. Ramon Tallaj Calls for Continued Focus on Zika in El Diario Op-ed

ACP Chairman Dr. Ramon Tallaj's op-ed emphasizes the need for continued attention and diligence around this devastating virus that has particular implications for the Latino community who travel frequently to affected areas like the Dominican Republic and Puerto Rico.

For more than six months, ACP has conducted an educational campaign regarding the Zika virus and its impact on the Latino community, including a dedicated Zika page, a video featuring ACP Chief Medical Officer Diego Ponieman, MD, MPH, and direct outreach to our community physicians. 

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Patients Needed! Diabetes Self-Management Program

ACP is pleased to offer a comprehensive, evidence-based, chronic disease self-management program for patients with diabetes, as part of DSRIP Project 3.c.i.
 
ACP Community Health Workers (CHWs) have been trained and certified in the Stanford Model and will lead community-based self-management workshops. The week-long training, taking place at ACP headquarters, is being facilitated by Health People, a community health agency based in the South Bronx. 

The Perfect Program Candidate:Image result for diabetes self-management

  • Type-2 Diabetes
  • A1C greater than 6.4
  • Medicaid recipient
  • Wants to learn how to control their blood sugar
Please contact Angela Lee or Migna Taveras to learn more about the Stanford Model program and to refer patients as candidates.
 
The Stanford Model is a chronic disease self-management initiative to engage patients in their care. Each workshop covers:
  • Techniques to deal with problems such as frustration, fatigue, pain and isolation;
  • Appropriate exercise for maintaining and improving strength, flexibility, and endurance;
  • Appropriate use of medications;
  • Communicating effectively with family, friends, and health professionals;
  • Nutrition

Free Training for eClinicalWorks Users

NYC REACH is offering a series of trainings to help practices’ staff become better acquainted with eClinicalWorks (eCW) electronic health record system. Registration is open to all NYC REACH members using eCW but limited to two registrants per practice. These trainings have been developed for a variety of skill levels, read on to determine which trainings are best for you!

Learn more and register here.

New Care Management Committee

A new Care Management Committee has been introduced to provide oversight and guidance to ensure ACP’s care management efforts meet DSRIP program goals to reduce avoidable hospitalization and Emergency Department (ED) utilization. The program provides care management services to chronically ill patients including assessing, planning, coordinating of services, patient education, and clinical monitoring to improve treatment adherence and disease self-management skills.
 
At the inaugural meeting in December 2016, Committee Chairperson Diego Ponieman, MD, MPH, said the committee will work to ensure high-quality,  timely, effective, patient-centered, and culturally sensitive care management services are delivered in a collaborative and integrated approach to our most at-risk Medicaid patients. 

The Committee is co-chaired by Richard Bernstein, MD, Consultant Medical Director. Members include Mario Paredes, President and CEO; Aran Ron, MD, Consultant Medical Director; Mary Ellen Connington, RN, MA, ACP Chief Operating Officer; Deaera Williams, RN Care Manager; Les Halpert, Ph.D., Clinical Psychologist; Soraya Sussman, MPAH, Senior Director Quality Management; Corey Maher, CTO; Tonguc Yaman, CIO; Gloria Wong, VP of Operations; Alexandro Damiron, VP and Chief of Staff, and Christina Lee, RN, Community Representative.

DASH Diet Workshops: Driving Nutritional Awareness In Our Communities

DASH – an acronym for Dietary Approaches to Stop Hypertension – is a well-balanced nutritional plan designed to treat or prevent high blood pressure and diabetes, and reduce the risk of heart disease and stroke. The plan, rich in fruits, vegetables, and whole grains, and low in sodium and sugar, has been selected as ACP’s recommended nutrition plan.

A series of interactive nutritional workshops are one element of ACP's culturally-competent DASH campaign. The seminars – complete with food demonstrations – address cultural and socioeconomic challenges and offer adaptable meal plans and food swaps following DASH guidelines.
 
Director of Integrated Outreach Denisse Oller, Chief Medical Officer Diego Ponieman, MD, MPH, and Care Manager Deaera Williams presented the first of three DASH diet workshops for ACP community health workers. The first focused on the prevention and treatment of diabetes using suggested food swaps for popular cultural dishes. The workshops will continue through the month of January. More photos on our Facebook page.

ACP Is Growing!

ACP’s headquarters is expanding to the fifth floor of 519 Eighth Avenue. Our new open workspace, designed to foster communication and collaboration, provides room for growth and alleviates overcrowding on the 14th floor.

Guests visiting the 5th floor are asked to check in first at our Reception desk on the 14th Floor to receive a visitor pass. Reception will notify your ACP host that you have arrived.

Our expansion comes almost exactly one year after ACP proudly moved to our offices on the 14th Floor, with just 35 employees barely filled the space! We begin 2017 with more than 100 employees, including 50 Community Health Workers who are helping to close care gaps by connecting patients with their PCPs, specialists, community organizations and other resources.

We are grateful for the resources provided through DSRIP that give us the opportunity to help transform health care for New York’s most vulnerable.



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