Cardiometabolic (CMB) Prescribing: Overview

Description

The Vida CMB Medical Prescribing Service (MPS) is an advanced service provided to members who are currently enrolled in a CMB program and who would benefit from the addition of working with a prescribing provider. 

What's considered a CMB Program?

• Asthma Management
• COPD Management
• DPP
• Heart Failure Focus
• WL+
• WH

What is being prescribed?

Core Service

• Lab Orders (A1C, HTN, HLD)
• Statins/ACE/ARBs for HLD/HTN control
• Medical Nutrition Therapy
• CGM

Advanced Service

• Lab Orders + Medication Prescribing & Management

Eligibility:

Launch Details

Pay Orgs: Northrup Grumman and Nuvance

 

2/16/23 - Initial 25 eligible members from both pay orgs.

• Rolling out to add 25 members after that every Tuesday/Thursday.

Type of Prescribers:

• Psychiatrist, Nurse Practitioner, Primary Care Physicians 

Inclusion Criteria:

• Adults age 18+ 
• Member must be currently enrolled in a CMB program and meet qualification criteria, which includes being in a pay org where CMB prescribing is enabled and meeting certain clinical criteria. 

The goal of the service:

• To effectively measure members’ progress over time and scale interventions up or down to meet their goals, and ultimately, drive even better results in higher acuity populations needing additional support.

Other FAQs about Vida’s CMB Prescribing Service:

Will the member have access to their prescriber?

• Members are able to chat with their prescriber through the app
• Members can also schedule consults with their prescriber through the app 

Will the prescriber assist with lab orders?

• Yes, Vida provides the lab order to the member, which can be found in the documents section in the Vida App. Members will complete the "Where you Live" survey indicating in which state they are currently located.  Additional info will be collected during the initial consult with the prescriber.

How long will it take to complete the labs? 

• Members should receive their lab orders within 3-5 business days after opting in to the service. The timeframe is subject to change if a consult is required first and when that would be scheduled and completed.
• Upon completing the test, members should confirm with their lab of choice the approximate timeline for the results to be sent back to Vida.

Where can members complete their lab work?

• Members can have their lab work done at their preferred lab and can update lab location by speaking with their prescriber or through a support request 

Will insurance cover the cost of their lab orders?

• Members will be able to provide their insurance information directly to the lab of their choice. Coverage of costs will vary depending on policy information. The member should reach out to their insurance company for any information about the cost of their lab work.

If a member changes pay org and no longer qualifies for Vida, how would they transition out CMB prescribing?

• There's a 30-day close-out period. So when identified from the start of a member no longer having access, that period starts. Essentially on the 1st of the month which member is notified of no longer being eligible.

How are lab results shared and communicated to the member?

• Lab results will be available in the member's “My Documents” section in Settings. They will receive a notification through Chat when new results are ready for their review. You should confirm with their lab of choice the approximate timeline for the results to be sent back to Vida.

• Please note: Some results may be ready sooner than others. In this case, they'll receive a notification when those results are ready, and another notification when the remainder of their results are ready.

Labs Incomplete: Some results ready notifications

Labs Complete: All results ready notifications

If one or more results are out-of-range...

• Members will be notified in the app and via email if one or more of their results is out of range. 

In-App Notification in Chat

 

Email Notification

If one or more results are CRITICAL...

• Members will be notified in the same way, but due to the critical nature, some additional action steps take place.
• Please instruct members to review the information provided in these content cards and take action. A member of their Vida Care team will also call the member within 24 hours to talk about getting medical care and follow-up. 

Critical Result Notifications

• Members will receive a content card in chat for each critical result.

 

The Care Team Experience

• When one of their members receives a critical lab result, providers will receive a task within the member's page in their dash to call the member within 24 hours to address the result.

• The Prescribing Team will also have an on-call slack channel. The prescriber that's on-call will monitor this channel and receive a slack message if a member's lab result(s) is critical. Their call-to-action is similar to the provider in that they reach out to the member within 24 hours.
  • Even if the on-call prescriber isn't the member's direct prescriber, the on-call provider will handle calling the member.

If members reach out about their out-of-range/critical results, use the macro Prescribing Support - Lab results showing out-of-range or critical to let them know their care team will be in touch to talk about the next steps. They can also proactively reach out to them via chat.

 

Support Team Workflow

When you receive a voicemail regarding a lab prescription for a member, assign the ticket to the Prod Ops Group. 

• Prod Ops will triage them and identify what prescriber the ticket should be routed.

 

Prescribing Translation Services

Members enrolled in Prescribing who have Spanish selected as their primary language will have services from an English Speaking provider translated into Spanish.

• For asynchronous or text-based services, translation will be completed by the Vida localization team
• For video calls, live translation will be provided by a third-part translation service called BoostLingo. This will be automatically enabled for calls with Prescribers to Spanish-speaking members
• An example of a 3-way call with translator included: