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Network Matters
News and Information for the
Harvard Pilgrim Health Care Network

February 2017

2016 Physician Group Honor Roll Announced


Harvard Pilgrim would like to congratulate the 52 physician groups in Massachusetts and Maine named to our 15th annual Physician Group Honor Roll. The annual Honor Roll highlights physician groups that have achieved exceptional results in their approach to disease prevention and the treatment of acute and chronic illness for both adult and pediatric patients.

Harvard Pilgrim selected the Honor Roll physician groups based on clinical performance measured against NCQA’s national HEDIS quality benchmarks in three domains of clinical care: acute, chronic, and preventive care. Physician groups were identified as Honor Roll practices based on performance on 15 measures, such as appropriate treatment for children with upper respiratory infection, comprehensive diabetes care, and breast cancer screenings. Nine of the 52 practices on the Physician Group Honor Roll achieved “With Distinction” status, meaning they exceeded NCQA’s national 90th percentile in all domains of clinical care.

Honor Roll physician groups are noted in Harvard Pilgrim’s Provider Directory, enabling members to evaluate and select providers based on quality and safety performance. To view the complete lists of this year’s recipients, and to learn more about Harvard Pilgrim’s methodology, please visit the 2016 Physician Group Honor Roll page.

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HPHCURRENT EVENTS

2016 Physician Group Honor Roll Announced

CLINICIAN CORNER

Newborn Level II-IV/NICU Admission Notification Policy

Prior Authorization for Non-Emergent Transportation

Update: Expanded Coverage for Esophagogastroduodenoscopy (EGD)

GERD: Endoscopic Treatments Medical Policy Updated

Updates to Artificial Cervical Disc Replacement Policy

Reminder: 90-day Supplies at Retail

Coordinating Care to Manage Weight Gain in Behavioral Health Patients

OFFICE ASSISTANT

Provider Manual Update and Balance Billing

Moderate Sedation Reimbursement for GI Endoscopic Procedures

PUBLICATION INFORMATION

Eric H. Schultz,
President and Chief Executive Officer

Robert Farias,
Vice President, Network Services

Annmarie Dadoly,
Editor

Joseph O'Riordan,
Writer

Kristin Edmonston,
Production Coordinator