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February, 2011

MICHIGAN ONCOLOGY CLINICAL TREATMENT PATHWAYS

PROGRAM NEWSLETTER

This email serves as a Pathways Program update from Oncology Physician Resource (OPR).
  
This issue features:

BCBSM PATHWAYS PARTICIPANT

REIMBURSEMENT RATES

Beginning January 1, 2011, professional reimbursement rates for select pharmaceuticals and evaluation and management codes were increased in support of the Pathways Program.  The increased rates will be paid only to oncologists participating in the program.

 

The enhanced Pathways Program fee schedule cannot be accessed through web-Dennis and is only distributed by OPR.  Updated fee schedule information will continue to be distributed as it becomes available.

bcbsm 

The following table includes all select pharmaceuticals addressed in the Pathways Program that have an enhanced fee: Click here for printable copy
 
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The following table includes all evaluation and management codes with a 10% enhanced fee:  Click here for printable copy

 

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PROGRAM COMPLIANCE

Year 2 Compliance Standard:

 

Clinical pathway compliance required for year 1 pathways: breast, colon, lung cancer (80%) and supportive care (80%)

 

Clinical pathway compliance required for year 2 pathways: lymphoma, myeloma, ovarian, prostate, renal cancer (70%), and supportive care (80%) 

 

Qtr. 1-3 Compliance Update:

 

Individual compliance information can be accessed through the Pathways web portal.

compliance 

Proportion of Participating Practices Achieving Compliance Thresholds for Both Treatment and Supportive Care Pathways:

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Proportion of Sites Meeting 70% Compliance Threshold by Tumor Type: 

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FOR PATHWAYS PROGRAM INQUIRIES CONTACT: 

 

 Jane M. Tozer

  Manager of Business Operations & Clinical Pathways
  

PHONE: 248-549-4057
FAX: 877-787-0595 

EMAIL: [email protected]

 

SAVE THE DATE

 

MI Clinical Pathways, MiBOQI, & QOPI Data Sharing Meeting

 

Friday, June 24, 2011
  
The Henry
Dearborn, MI
  
REMINDER
 
The Pathways fax form is an optional program feature.  When the fax form is completed and returned extra credit toward compliance is given.
  
Click the link below for the
UPDATED form: