Quality Toolkits
The Physician Alliance created health toolkits to provide a variety of resources focused on specific health conditions. The materials and outreach tools can help initiate conversations with patients to increase knowledge and skills for managing their health. Coding and other documents can assist with practice performance and improved quality metrics.
The Physician Alliance members can access the toolkits on the home page of the portal by clicking here to log in.
New- Care Management Toolkit
TPA created a Care Management Toolkit to help support practices in population health outcomes by offering a patient-centered approach for care management. Along with using electronic medical records to identify affected patients to initiate outreach, practices can utilize the following resources to engage patients with behavioral and chronic conditions, including addressing social determinants of health.
Patient education materials are available for behavioral health care management and care management services along with practice tips on the importance of scheduling 7-day post-discharge appointments and tips for patients on how to avoid another hospital stay.
Additional resources include:
- Transitional care management payor coding tip sheet
- Medication reconciliation post-discharge tip sheet
- Tips for lowering & taking blood pressure pad (with patient tracking sheet) handout
- “Ask us first” urgent care poster
Community Health Services Toolkit
Health disparities and social determinants of health (SDOH), such as socioeconomic status, environment, and social support systems, are factors that can impact patient health outcomes. The Physician Alliance SDOH Community Health Services toolkit offers resources to member practices to assist patients with SDOH. The following resources were created to help promote the non-medical support available through TPA’s community health worker (this service is complimentary to TPA’s PGIP practices).
Resources for patient education:
- Flyers to promote non-medical community health services to patients (with phone number to call TPA’s community health worker). These flyers are also available with tear-off phone number tabs.
- Social media graphics promoting non-medical community health services for practices to utilize on their websites, patient portal, et.
Practice staff resources supporting SDOH include:
- Flyer that informs staff of available patient support TPA’s community health worker can assist with.
- Brief video that shows how to submit a community health assistance referral form.
- Social determinants of health Z codes tip sheet.
Diabetes Management Toolkit
Practices can educate and provide resources to patients to engage them in managing their disease and reduce risks for diabetes complications. Examples of materials in the diabetes toolkit include:
• Patient education flyers on diabetes management, the importance of eye exams, lowering risk of diabetes and more
• Understanding diabetic retinopathy infographic
• Social media graphics promoting diabetes management and retinal eye exams
• Coding tip sheets and more!
Gaps in Care Toolkit
Patient outreach and ongoing communication efforts help practice staff better coordinate needed care. Examples of materials in the gaps in care toolkit include:
- Patient posters, checklists and more
- Patient action plans
- Letter template to remind patients about lapsed health appointments, screenings, etc.
- Social media graphics
Where to Get Care Toolkit
This toolkit focuses on educating patients on where to seek care. An unnecessary emergency department visit may lead to unneeded tests and higher out-of-pocket costs for patients. Examples of materials in the emergency department toolkit include:
• Customizable urgent care handout (to include urgent care facilities the practice partners with)
• Social media graphics
• Where to seek care infographic- view flyer
• Sample script for after-hours care
• Telemedicine tips and more!