Provider Network Newsletter
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New Pharmacy Manager
Meet Mike Durgin
Beacon Health Website
A Consumer's View
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Issue: # 2June 2015

The school buses are out, apples are being picked, and football is being played, no doubt the offical start of fall is right around the corner.
We hope you are enjoying the beautiful weather and are making plans to take is some the fall foliage!
If there's something we can help you with, please be sure to reach out to us.
Happy fall,
The Beacon Health Provider Network Team

Acronyms of the Month

Because they're just a part of healthcare!


 Can you decode the healthcare acronyms below?

  • ACA               _________________________________
  • CAH               _________________________________
  • CoP                _________________________________
  • ERISA            _________________________________
  • PQRS             _________________________________

  Find the answers at the end of the newsletter.

Beacon Health's New Pharmacy Manager
a New Member of  Your Team...
 It seems almost daily we hear news of a new drug on the market that claims to help patients live healthier, more fulfilling lives. The pharmaceutical companies do a great job marketing their products to our patients, but it's our job to have meaningful conversations with our patients about their options and what might work best for them.
To help educate you and your healthcare team on how new prescriptions and over-the-counter drugs will work for your patients and interact with their current prescription(s), Beacon Health has added a new member to the healthcare team. Will Seavey, RPh is Beacon Health's new pharmacy manager. According to Will, "since medications are a vital part to the care of chronic disease, educating providers on where these new therapies fit into current treatment regimens is an important role."
That's just one of the many ways Will is here to support you in providing the highest quality patient care. Building a network of community pharmacists will be another focus. "These pharmacists can be some of the most accessible, high touch medical professionals that see your patients, so engaging them in our work can only improve the care of the population," explains Will.
Will is also working on improving patient access to specialty therapies at home when appropriate, promoting generic medications when possible, standardizing the process of sharing a patient's medication list across care transitions, and helping patients who need one on one time with a pharmacist get that time. "Often, patients are having side effects or can't afford their medications. With a pharmacist on the team, we can help address these barriers and improve health outcomes as a result."
 Since the early days of Beacon Health, Will has been sharing his knowledge and expertise with lead providers across the network with his more than eight years' experience as an inpatient pharmacist at Eastern Maine Medical Center, as well as working at Miller Drug. We are excited to have Will join our team on a fulltime basis.
As pharmacists become more common place throughout the primary care practices of Beacon Health, they will work alongside Will on performance improvement efforts related to medication and quality outcomes. If you have any questions, please don't hesitate to call or email Will, 207-973-8941 or
Introducing... Mike Durgin, Network Manager
      Mike Durgin is the network manager for Beacon Health overseeing the contracting, credentialing, and reporting for the network providers, as well as provider relations for the network. He earned his bachelor of science degree from Husson University. Mike entered the healthcare field after a twenty-year career in the financial industry.
He began his new career at Penobscot Community Health Care in Bangor and worked as their credentialing coordinator, managing the onboarding and enrollment of all their providers. Three years ago, Mike joined Eastern Maine Medical Center as their medical staff coordinator until joining the Beacon Health team in February.
Mike is a nationally certified provider credentialing specialist (CPCS) and a member of both MeAMSS (Maine Association of Medical Staff Services) and NAMSS (National Association of Medical Staff Services). Mike lives in Winterport with his girlfriend where they spend much of their time outdoors kayaking, hiking, and snowshoeing.
Beacon Health Website is There to Help
Beacon Health has been adding reference materials and other content to our website to make it more useful to our provider network. In addition to the all-important profiles and photos of network management staff, we have posted a number of tools that you can use in your work with Beacon Health and the EMHS Employee Medical Plan (Geisinger Health Plan):
  • Credentialing Forms - here you can download forms for:
    • adding or changing data on providers for Geisinger claims payment;
    • notifying Beacon Health of new administrative staff;
    • documenting providers who do not maintain a DEA certificate; or
    • establishing a unique insystem NPI-2 (Group NPI) to allow your claims to process as "In System" when procedures are performed at an EMHS facility.
  • Geisinger Provider Guide - open or download the provider manual for interacting with the Geisinger Health Plan as the administrator for the EMHS Employee Medical Plan
  • Benefit table for the EMHS Plan - open or download a summary table of EMHS plan benefits for in system, in network or out-of-network levels of benefits
  • Contact names and information for Beacon Health network management
  • Currently, the website's URL is long for you to enter (, but we are working to shorten the URL.. Meanwhile, please enter it into your browser, make sure you have all the hyphens correct, and then bookmark it for your reference.  
    We hope you find these features and future improvements helpful! If you have questions or suggestions, contact Beacon Health's network manager, Mike Durgin at
    or (207) 973-6689.
Population Health: 
A Consumer's View of Healthcare Changes
David Small 
Dave Small, of Old Town, has seen an industry go through rapid change. He was a manager in the business office at the Bangor Daily News until 2005. At that time, and even more so today, Dave has seen an industry that has needed to reinvent itself in order to stay ahead of the curve within a world that is becoming much more technologically advanced.
Similar to the newspaper industry, the healthcare industry has also had to undergo reinvention. As a consumer representative at Beacon Health's population health meetings, Dave now advises our practice leaders on how patients experience our healthcare network and the widespread changes affecting our industry.
At the BDN, Dave's focus was on customer service. Now, he also recognizes that primary care practices need to transform their patient-centered care processes. Whether it is thank-you notes to new patients or calls to patients recently discharged from the hospital, Dave approves of the heightened awareness of practices on what is happening to their patients outside of the office.
Speaking at the recent EMHS Governance Summit, Dave told board members that the Beacon Health nurse care coordinators are a critical element in delivering the right care, at the right time, and in the right place. In managing his diabetes, he has experienced health insurers using similar programs, but not as effectively. Dave shares, "Health plans appeared to be monitoring, not helping. A nurse that's located right in my doctor's practice has more complete information and a closer, established relationship to help me handle challenges and manage my chronic conditions."
Two other developments within practices strike Dave as very important. Depression screening is critical to identify patients who might otherwise be reluctant or unable to report this co-morbidity that makes any illness much more complex and expensive. Similarly, an in-practice pharmacist is a great resource for patients, as Dave recently experienced when the pharmacist helped him to organize and improve his medication regime.
"I'm very impressed with the dedication behind improving population health. I appreciate the effort and creativeness that is required to keep both patients and practice thriving and healthy in these tumultuous healthcare times!"


    • ACA - Affordable Care Act (also known as the Patient Protection and Affordable Care Act, PPACA); A federal statute that was signed into law by President Barack Obama on March 23, 2010. Along with the Health Care and Education Reconciliation Act of 2010 (HCERA, signed into law on March 30, 2010), provisions of the legislation include: increasing health insurance coverage, expanding Medicaid eligibility, improving quality and efficiency of medical care services, subsidizing insurance premiums, prohibiting denial of coverage/claims based on pre-existing conditions, providing incentives for businesses to provide healthcare benefits, and supporting healthcare workers through a new workforce training and education infrastructure.
    • CAH - Critical Access Hospital; A designation by Medicare that is reserved for hospitals meeting certain criteria related to access to services. CAHs are typically small, inpatient facilities that represent the only source of inpatient and/or emergency care in a defined geographic (often rural) area. CAHs are subject to additional regulations from Medicare. Often designated as sole community hospitals, they are also typically eligible for upward adjustments in payments from Medicare.
    • CoP - Conditions of Participation (Medicare); Developed by CMS, Conditions of Participation (CoPs) and Conditions for Coverage (CfCs) are the minimum health and safety standards that healthcare providers and suppliers must meet in order to be Medicare and Medicaid Certified.
    • ERISA - Employee Retirement Income Security Act; A federal law that sets minimum standards for most voluntarily established pension and health plans in private industry to provide protection for individuals in these plans.
    • PQRS - Patient Quality Reporting System (formerly known as Patient Quality Reporting Initiative (PQRI); A quality reporting program that encourages individual eligible professionals (EPs) and group practices to report information on the quality of care to Medicare. PQRS gives participating EPs and group practices the opportunity to assess the quality of care they provide to their patients, helping to ensure that patients get the right care at the right time. By reporting on PQRS quality measures, individual EPs and group practices can also quantify how often they are meeting a particular quality metric.