Health Services Advisory Group (HSAG) provides services to physician offices in Arizona and California for chronic disease management, such as blood pressure control, diabetes care, smoking cessation, cardiac rehabilitation, and chronic kidney disease (CKD) care.
Program participants will find their work on these measures simultaneously enhances their current efforts to transition to value-based payment models and participate successfully in the federal Quality Payment Program (QPP). Contact us to register for services and receive no-cost technical assistance.
Chronic Disease Management
- PreventT2 virtual webinars flyer (PDF)—Attend no-cost, diabetes prevention webinars weekly on Tuesdays in Spanish and English.
- Find a diabetes self-management education (DSME) program near you: https://www.diabetes.org/tools-support/diabetes-education-program
- Healthcare Provider Diabetes Prevention Toolkit: https://amapreventdiabetes.org/
- Provider Telehealth Checklist (PDF)
- 60-Second Type 2 Diabetes Risk Test: https://donations.diabetes.org/site/SPageServer/?pagename=Diabetes_Risk_Test&source=ADA&cate=STAFF&loca=VA&adas=90400
- Self-Care Behaviors to Manage Diabetes: https://www.diabeteseducator.org/living-with-diabetes/Tools-and-Resources
- Teach-back resources: http://www.teachbacktraining.org/using-the-teach-back-toolkit
- About DSMEs: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/DSMT-Fact-Sheet-909381Print-Friendly.pdf
- 2023 Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%) Medicare Part B Claims Measure Specification Sheet (PDF)
- A Toolkit to Engage High-Risk Patients in Safe Transitions Across Ambulatory Settings
- Hypertension Control Change Package for Clinicians (PDF): https://millionhearts.hhs.gov/files/HTN_Change_Package.pdf
- Self-Measured Blood Pressure Monitoring (SMBP):
- SMBP Action Steps for Clinicians (PDF): https://millionhearts.hhs.gov/files/MH_SMBP_Clinicians.pdf
- Reimbursement for Hypertension Self-management: SMBP CPT® coding (PDF): https://www.ama-assn.org/system/files/2020-06/smbp-cpt-coding.pdf
- Proper Technique for Accurate Blood Pressure Measurement (PDF)
- 2017 Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults (PDF): https://www.acc.org/~/media/Non-Clinical/Files-PDFs-Excel-MS-Word-etc/Guidelines/2017/Guidelines_Made_Simple_2017_HBP.pdf
- Supporting Your Patients with High Blood Pressure (PDF): https://millionhearts.hhs.gov/files/TipSheet_HCP_Checklist.pdf
- Atherosclerotic Cardiovascular Disease (ASCVD) Risk Estimator: https://tools.acc.org/ascvd-risk-estimator-plus/#!/calculate/estimate/
- Cardiac Rehabilitation Change Package (PDF): https://millionhearts.hhs.gov/files/Cardiac_Rehab_Change_Pkg.pdf
- Clinician Recognition Programs:
- Target BP Recognition Program: https://targetbp.org/recognition-program/
- Hypertension Control Challenge: https://millionhearts.hhs.gov/partners-progress/champions/challenge.html
- 2023 Controlling High Blood Pressure Medicare Part B Claims Measure Specification Sheet (PDF)
- A Toolkit to Engage High-Risk Patients in Safe Transitions Across Ambulatory Settings
- Provider Telehealth Checklist (PDF)
- Connected Care Toolkit (PDF)—CMS provides information for healthcare professionals on the requirements for providing chronic care management (CCM) in practices and eduational materials to share with patients.
- CCM Highlights (YouTube video)
- Transitional Care Management (TCM) (YouTube video)
- CCM Comprehensive Care Plan (PDF)
- Quality Data Codes for High Blood Pressure and HbA1c (PDF)
Quality Payment Program
- 2023 Quality Payment Program (QPP) Final Rule Resources (ZIP)
- 2023 MIPS Quick Start Guide for Small Practices (PDF)
- 2023 MIPS Quick Start Guide (PDF)
- 2023 MIPS Quality Measures List (XLSX)
- Are MVPs Right for Me?
- 2023 MVPs Implementation Guide (PDF)
- Optimizing Chronic Disease Management MVP Toolkit (ZIP)
- 2022 QPP Documents for an Audit (PDF)
Physician Practices Newsletter
Emergency Preparedness
- Physician Business Continuity Plan (PDF)—The Business Continuity Plan (BCP) is a living document that comprises resources, policies, and procedures to be used in the event of a disaster or major disruption of operations. The BCP is one way to help practices limit disruption to crucial patient care services, where applicable, and minimize adverse economic impact by resuming normal operations as quickly as possible.
- Centers for Disease Control and Prevention (CDC) Emergency Action Plan (PDF)
