HSX offers Comprehensive Primary Care Plus (CPC+) Program participants a variety of services tailored to strengthen primary care. During implementation, the HSX Engagement and Adoption Team works with the CPC+ participants to ensure services are deployed in ways that meet organizational needs and promote patient-centered care.
Performance Reporting Portal (PRP)
The CPC+ Performance Reporting Portal (PRP) provides the CPC+ participant quarterly performance reports from the aggregated claims data. The claims data are derived from HSX members Aetna and Independence Blue Cross, as well as the Centers for Medicare & Medicaid Services Medicare. The PRP can assist provider practices with reviewing measures within the reporting period, evaluating individual and practice level data, and monitoring trends over time.
HSX Encounter Notification Service
The HSX Encounter Notification Service (ENS) supports the Care Management and Comprehensiveness and Coordination requirements of the CPC+ Program. With HSX providing notifications for selected patients, CPC+ participants can optimize their follow-up procedures for their patients’ emergency department visits. This will satisfy the requirement for follow-up with patients one week after discharge from an emergency department.
To providers and payers who subscribe to the ENS, HSX delivers a notification when one of their patients or members is hospitalized or presents to an emergency department or post-acute care facility. Subscribing providers and payers can also be notified when their patients or members are discharged from emergency departments, hospitals, or post-acute care facilities that participate with HSX.
HSX Condition-Specific Notifications
As an upgrade to the regular HSX Encounter Notification Service, CPC+ participants and providers have the capability to customize encounter notifications by discharge diagnosis. HSX uses Hierarchical Condition Categories (HCC) to group the ICD codes for the condition-specific notifications based upon CPC+ participant preference. For example, HSX can provide notifications when a patient is discharged with an opioid-related disorder, to support targeted intervention within the primary care setting.