CHESS Health Solutions

11/19/2025

Medication adherence is key to managing diabetes, but patients face barriers like complex regimens, cost, and misconceptions.

Strategies that help:
+ Educate patients on treatment and outcomes
+ Simplify medication routines
+ Use tech for reminders and support
+ Collaborate with pharmacists and care teams

A holistic, patient-centered approach can improve adherence and outcomes.

How does your practice support patients in staying on track with their diabetes medications?

11/18/2025

CHESS Value ACO helped avoid 810+ hospital admissions, prevent 2400 emergency department visits, and reduce 220+ skilled nursing facility admissions.

That's the value of partnership and a shared commitment to driving meaningful change in healthcare.

11/17/2025

While both Medicare and Medicaid play crucial roles in providing healthcare coverage, they serve distinct populations with unique needs:

➡️ Medicare is a federal program primarily for individuals aged 65+ or those with certain disabilities. It offers hospital, medical, and sometimes prescription coverage.

➡️ Medicaid is a joint federal-state program designed to assist low-income individuals of all ages, offering comprehensive services that can include long-term care and supports.

Understanding the nuances of these programs can help you guide your patients to the right resources. Knowing which program fits their needs ensures they receive the coverage they deserve!

11/14/2025

📢 New ICD-10 Code Alert: E11.A – Type 2 Diabetes in Remission

Starting October 1st, providers can now document Type 2 diabetes in remission with the new ICD-10 code E11.a. This helps track patient outcomes more accurately and reflects the success of lifestyle or treatment interventions.

Key Points for Providers:
✅ Remission Criteria: HbA1c < 6.5% for at least 6 months without glucose-lowering meds
✅ Documentation Tips: Avoid terms like "resolved" or "history of"
✅ Ongoing Monitoring: Regular follow-ups are essential to prevent relapse

11/13/2025

Let's talk about something important. As the winter sets in, let's remember that some patients may struggle more with their mental health during this season.

Depression can deepen in colder months, impacting many aspects of daily life.

As healthcare providers, let's ensure we're attuned to these challenges and offer support beyond physical ailments. Encourage open conversations, provide resources, and guide patients towards more holistic care.

When screening for depression, follow these tips and best practices to ensure your efforts are documented accurately.

https://www.chesshealthsolutions.com/2025/04/08/coding-corner-major-depressive-disorder-documentation-coding/

11/12/2025

Prior authorizations don't have to overwhelm providers.

Pharmacists can ease the burden by:
✔️ Recommending alternatives that avoid prior auths
✔️ Supporting documentation to reduce denials
✔️ Flagging high-cost meds early
✔️ Guiding patients through the process

Collaboration with pharmacists streamlines care and gets patients the treatment they need faster.

11/11/2025

Today, we honor and celebrate all veterans.

Thank you to all who have served. We are grateful for your dedication and sacrifice.

Happy Veterans Day!

11/07/2025

Myth: Care coordination is the same as case management.

Fact: While both are critical to patient care, they serve different purposes. Care coordination focuses on aligning care across multiple providers and settings, whereas case management is often condition or episode specific.

11/06/2025

We are back with Emily Volk, Director of Quality, Risk, and Compliance at Northern Regional Hospital.

Emily shares how her team is making Medicaid managed care easier through EMR tools and strong partnerships.

What you will learn:
✅ Smarter Medicaid reporting
✅ EMR workflows that improve continuity of care
✅ Data and automation for better patient outreach
✅ How CHESS helps fill care gaps and reduce hospitalizations

If you work in value-based care or care coordination, this episode is packed with practical takeaways.

Emily Volk shares how Northern Regional tackles documentation, care coordination, and data challenges in Medicaid managed care.

11/05/2025

With over 37 million Americans affected, diabetes is more than just a health challenges; it's an epidemic that requires a concerted effort.

This , let's focus on prevention, early detection, and patient education.

Together, we can provide comprehensive diabetes care that helps patients manage their condition and prevent complications.

How will you contribute to improving diabetes this month? 💡

11/03/2025

Through the collaboration of our providers, care teams, and partners, the CHESS Medicaid Clinically Integrated Network (CIN) continues to make measurable progress in improving outcomes and reducing unnecessary utilization across North Carolina.

Together, we're supporting Medicaid members with the right care, at the right time, in the right place.

👉 Message us to learn more about how CHESS is transforming care for Medicaid populations across North Carolina.

10/31/2025

🚨 NC Medicaid Work Requirements Are Changing

Starting in 2027, non-disabled adults without dependents must complete work, education, or volunteering to maintain coverage.

Providers can help by:
+ Checking Medicaid eligibility at each visit
+ Educating patients about requirements
+ Documenting referrals and support

Proactive engagement helps keep patients covered and care continuous.