Health Services Advisory Group (HSAG) provides services to physician offices in Arizona and California for chronic disease management, such as blood pressure control, diabetes care, smoking cessation, cardiac rehabilitation, and chronic kidney disease (CKD) care.
Program participants will find their work on these measures simultaneously enhances their current efforts to transition to value-based payment models and participate successfully in the federal Quality Payment Program (QPP). Contact us to register for services and receive no-cost technical assistance.
Chronic Disease Management
- Diabetes Zone Tool (English/Spanish)(PDF)
- PreventT2 virtual webinars flyer (PDF)—Attend no-cost, diabetes prevention webinars weekly on Tuesdays in Spanish and English.
- Find a diabetes self-management education (DSME) program near you: https://www.diabetes.org/tools-support/diabetes-education-program
- Healthcare Provider Diabetes Prevention Toolkit: https://amapreventdiabetes.org/
- Provider Telehealth Checklist (PDF)
- 60-Second Type 2 Diabetes Risk Test: https://donations.diabetes.org/site/SPageServer/?pagename=Diabetes_Risk_Test&source=ADA&cate=STAFF&loca=VA&adas=90400
- Self-Care Behaviors to Manage Diabetes: https://www.diabeteseducator.org/living-with-diabetes/Tools-and-Resources
- Teach-back resources: http://www.teachbacktraining.org/using-the-teach-back-toolkit
- About DSMEs: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/DSMT-Fact-Sheet-909381Print-Friendly.pdf
- 2023 Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%) Medicare Part B Claims Measure Specification Sheet (PDF)
- A Toolkit to Engage High-Risk Patients in Safe Transitions Across Ambulatory Settings
- Kidney Disease Zone Tool (English/Spanish)(PDF)
- Attend a no-cost Kidney Smart class to learn more about what causes kidney disease and how patients can help slow its progression. This class is best suited for patients with less than 60% kidney function (Stage 3 to 5, eGFR less than 60) and their caregivers. Find a virtual, telephonic, or in-person class near you: Kidney Smart Patient Flyer (PDF)
- CKD Quick Reference Guide for Primary Clinicians (PDF) from the National Kidney Foundation (NKF)
- Clinical practice guideline for Cardiovascular Disease and CKD from Kidney.org
- Clinical practice guideline for Diabetes and CKD from Kidney.org
- Optimal Care for Kidney Health MIPS Value Pathway from CMS
- Just Diagnosed With CKD for Patients from the American Kidney Fund (AKF)
- CKD Frequently Asked Questions (PDF) from NKF and the American Society for Clinical Pathology (ASCP)
- Eating Right for CKD from National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
- Heart Disease Zone Tool (English/Spanish) (PDF)
- Hypertension Control Change Package for Clinicians (PDF): https://millionhearts.hhs.gov/files/HTN_Change_Package.pdf
- Self-Measured Blood Pressure Monitoring (SMBP):
- SMBP Action Steps for Clinicians (PDF): https://millionhearts.hhs.gov/files/MH_SMBP_Clinicians.pdf
- Reimbursement for Hypertension Self-management: SMBP CPT® coding (PDF): https://www.ama-assn.org/system/files/2020-06/smbp-cpt-coding.pdf
- Proper Technique for Accurate Blood Pressure Measurement (PDF)
- 2017 Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults (PDF): https://www.acc.org/~/media/Non-Clinical/Files-PDFs-Excel-MS-Word-etc/Guidelines/2017/Guidelines_Made_Simple_2017_HBP.pdf
- Supporting Your Patients with High Blood Pressure (PDF): https://millionhearts.hhs.gov/files/TipSheet_HCP_Checklist.pdf
- Atherosclerotic Cardiovascular Disease (ASCVD) Risk Estimator: https://tools.acc.org/ascvd-risk-estimator-plus/#!/calculate/estimate/
- Cardiac Rehabilitation Change Package (PDF): https://millionhearts.hhs.gov/files/Cardiac_Rehab_Change_Pkg.pdf
- Clinician Recognition Programs:
- Target BP Recognition Program: https://targetbp.org/recognition-program/
- Hypertension Control Challenge: https://millionhearts.hhs.gov/partners-progress/champions/challenge.html
- 2023 Controlling High Blood Pressure Medicare Part B Claims Measure Specification Sheet (PDF)
- A Toolkit to Engage High-Risk Patients in Safe Transitions Across Ambulatory Settings
- Provider Telehealth Checklist (PDF)
Quality Payment Program
- 2023 Quality Payment Program (QPP) Final Rule Resources (ZIP)
- 2023 MIPS Quick Start Guide for Small Practices (PDF)
- 2023 MIPS Quick Start Guide (PDF)
- 2023 MIPS Quality Measures List (XLSX)
- Are MVPs Right for Me?
- 2023 MVPs Implementation Guide (PDF)
- Optimizing Chronic Disease Management MVP Toolkit (ZIP)
- 2022 QPP Documents for an Audit (PDF)
Physician Practices Newsletter
- The Check Up, Vol.2, Qtr.4 - December 1, 2023
- The Check Up, Vol.2, Qtr.3 - September 1, 2023
- The Check Up, Vol.2, Qtr.2 - June 1, 2023
- The Check Up, Vol.2, Qtr.1 - March 1, 2023
- The Check Up, Vol.1, Qtr.4 - December 1, 2022
- The Check Up, Vol.1, Qtr.3 - September 1, 2022
- The Check Up, Vol.1, Qtr.2 - June 1, 2022
- The Check Up, Vol.1, Qtr.1 - March 9, 2022
Emergency Preparedness
- Physician Business Continuity Plan (PDF)—The Business Continuity Plan (BCP) is a living document that comprises resources, policies, and procedures to be used in the event of a disaster or major disruption of operations. The BCP is one way to help practices limit disruption to crucial patient care services, where applicable, and minimize adverse economic impact by resuming normal operations as quickly as possible.
- Centers for Disease Control and Prevention (CDC) Emergency Action Plan (PDF)
