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Letter from Medical Director
Dear Providers,
“Sara Thomas Monopoli was pregnant with her first child when her doctors learned that she was going to die,” is the dramatic start to a New Yorker article by Dr. Atul Gawande. The article describes the challenges clinicians face having honest discussions about prognosis, and the probability of treatment success. “There is almost always a long tail of possibility, however thin. What’s wrong with looking for it?
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Shannon Thyne, MD Receives IZ Champion Award
Pertussis (whooping cough) has become an epidemic in California with more than nine deaths reported among young infants over the past six months. Shannon Thyne, MD, Medical Director at Children’s Health Center (CHC), is working hard with her colleagues at SFGH to prevent any more deaths from this epidemic. In August, she received the IZ (immunization) Champion Award from the San Francisco Immunization Coalition for her work to immunize family contacts of newborns.
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Prevent the Spread of Pertussis in San Francisco County through Vaccination!
Vaccination recommendations from the California Department of Public Health:
- Children need five doses of DTaP by kindergarten (ages 4-6) and a Tdap booster at age 11 or 12.
- Adults need a tetanus/diphteria (Td) booster every 10 years and a 1-time dose of Tdap for protection from pertussis is recommended to replace the next Td.
- There is no required waiting interval between Td and Tdap.
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Pitfalls of Oxycontin Use
Oxycontin facts:
- Oxycontin is the fifth most commonly prescribed drug for SFHP members in terms of cost, and SFHP spends $150,000 on Oxycontin each year, with an average annual cost of $8,000 for each Oxycontin user.
- Oxycontin has a street value of one dollar or more per milligram. For the average SFHP Oxycontin user, diversion could provide income over $50,000 per year.
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SFHP’s Provider Network is the Best in California!
Our Health Effectiveness Data and Information Set (HEDIS) measure scores prove it: For care provided in 2009, SFHP won Medi-Cal’s Gold Medal Award for the state’s highest HEDIS scores for the third year in a row
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Brown &Toland Physicians Joins SFHP Provider Network as of November 1
We are very pleased to announce that Brown & Toland Physicians will join the San Francisco Health Plan (SFHP) provider network effective November 1, 2010. SFHP is thrilled to have the opportunity to partner with Brown & Toland Physicians to give our members access to high quality and affordable healthcare.!
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Providing Access to Health Care (PATH)—Expanding Managed Care to Seniors and Persons with Disabilities and the Importance of Using “People First” Language
It is still very likely that the State may start mandatorily enrolling seniors and persons with disabilities (SPDs) into managed Medi-Cal in 2011. The State’s proposed enrollment roll-out start date has now been pushed back from February 2011 to June 2011. San Francisco Health Plan (SFHP) views this project as a top organizational priority and is taking the necessary steps to ensure that providers, community advocates and the health plan are ready for the enrollment of SPDs.
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Strengthening Strength in Numbers
Since the beginning of Strength in Numbers in 2009, many Healthy San Francisco (HSF) Medical Homes have made great strides in managing the quality of care in their clinics. We have seen improvements in two main areas:
- Increased capacity to manage and act on quality data
- Better care processes and outcomes for diabetes and for other chronic conditions measured in the program
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Interpreter Services
Limited English Proficient (LEP) Members of San Francisco Health Plan (SFHP) have the right to access quality interpreter services. It is the responsibility of medical providers and office staff to ensure that the members have access to these services at all medical points of contact.
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Reinstatement of Optometry Services to Adult Medi-Cal Members
Effective July 26, 2010 optometry services benefits (eye exams only) have been reinstated to adult Medi-Cal members ages 21 and older.
NOTE: No changes have been made to the vision benefits of Medi-Cal members under the age of 21 years old.
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Updates from July 2010 P&T Committee for Medi-Cal, Healthy Families and Healthy Kids
Smoking cessation products added to formulary with no prior authorization required!
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What’s New on the Website?
Do you need CME credits or would like additional training? Visit the Events section of the San Francisco Health Plan (SFHP) website to view upcoming forums, webinars, and trainings that are available to SFHP providers. Don’t forget to check back every now and then because this section is updated as we are informed about new events!
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