Welcome to Provider's Corner! This section of our website is customized to meet your needs and will include useful tips and ideas for practices and procedures you need to complete for NCQA, Buckeye and Ohio Department of Medicaid requirements. The intent is to create an easy-to-use, one-stop shop with helpful specifics around Quality measures, such as HEDIS, CAHPS and clinical processes you can use to meet the criteria for these requirements. Be sure to bookmark this page to make it easy to return when you need to reference content. We hope you find this helpful and are open to topics you’d like discussed on the site.
Flu season is here, and your recommendation matters! Studies show that a strong provider recommendation is the most influential factor in a patient’s decision to get vaccinated. Here are some quick tips to guide your conversations:
- Start with a clear, confident recommendation: Patients trust your advice—make it personal and specific to their health risks.
- Address common concerns: Explain that side effects are usually mild and short-lived and emphasize the vaccine’s long safety record.
- Highlight the benefits: The flu shot reduces severe illness, hospitalizations, and protects vulnerable groups like older adults, pregnant patients, and those with chronic conditions.
- Make it easy: Offer the vaccine during the visit or help schedule it. Convenience boosts uptake.
- Connect to community impact: Remind patients that vaccination protects not only them but also their family and community.
Your proactive approach helps prevent illness and saves lives. Let’s make this flu season safer for everyone!
At Buckeye Health Plan, we know that patient safety starts with proactive measures and we’re committed to supporting providers with practical tools that make a measurable difference.
Preventing infections in outpatient care clinics can bring unique challenges during flu and respiratory virus season. Unlike hospitals, many clinics operate without dedicated infection control teams and even minor lapses in infection prevention can result in avoidable harm.
These essential, evidence-based practices recommended by the Centers for Disease Control and Prevention (CDC) can help outpatient teams prevent infections, protect patient safety, and maintain trust in the care they deliver.
Key Recommendations
- Prepare for the respiratory season: Evaluate cleaning protocols, assess vaccination inventory, ensure adequate PPE and cleaning supplies are available, and establish best practice standards for hand hygiene and respiratory etiquette.
- Instrument Sterilization and High-Level Disinfection: Ensure reusable medical devices are cleaned, disinfected, and sterilized per manufacturer and CDC guidelines.
- Staff Education and Training: Provide regular training on infection prevention policies, procedures, and updates. Assess staff competency and reinforce best practices.
- Antimicrobial Stewardship: Implement strategies to promote appropriate use of antibiotics and reduce antimicrobial resistance. Educate staff and patients on antibiotic resistance.
- Surveillance and Disease Reporting: Monitor for healthcare-associated infections and report notifiable diseases to public health authorities as required. Conduct routine risk assessments.
Buckeye Health Plan is dedicated to making patient safety a shared priority. By taking these crucial steps now, we can help prevent infections, protect patients, and keep your clinic running smoothly all season long. Together, we can transform the health of the communities we serve, one person at a time.
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Closing care gaps start with proactive outreach. Here are quick strategies to make a difference:
- Review patient lists regularly: Identify those overdue for preventive services or screenings.
- Leverage EMR alerts: Use reminders and automated outreach (texts, calls) to keep patients on schedule.
- Make it convenient: Offer same-day appointments or help schedule follow-ups during visits.
- Educate and empower: Explain why preventive care matters—early detection saves lives and reduces complications.
- Connect to community impact: Remind patients that staying up to date protects their families and communities.
- Care Coordination: Offer help to patients who need appointments with specialists as soon as possible.
- After-hours Services: Have an after-hours care plan for your patients and educate your patients how to obtain after-hour care.
- Prescription Refills: Offer appointments or refills via text or email and refill directly to patient’s choice pharmacy.
- Alternative Visits: Office telehealth visits versus in-person visits if appropriate.
Every conversation is an opportunity to improve health outcomes—start today!
Your proactive engagement makes a measurable difference in patient outcomes. Start today—review your patient list, identify those due for preventive care, and reach out. Every conversation is an opportunity to protect health and save lives. Let’s work together to close gaps and keep our communities healthier!
Preventive Care for Children Ages 0–2
Early childhood is a critical window for growth and development. Your guidance during well-child visits helps families build healthy habits and prevent serious conditions. Here are key points to emphasize:
- Schedule and Promote Well-Child Visits 2-3 days after coming home from the hospital. The American Academy of Pediatrics recommends visits at newborn, 1, 2, 4, 6, 9, 12, 15, 18, and 24 months.
- Use EMR alerts and outreach (texts, calls) to keep families on track.
- Measure head circumference, length/ height, weight, BMI and age-appropriate exams.
- Cover topics during exams: Development progress, newborn screenings, hearing issues, vision problems, immunizations as applicable and labs/test and screening as applicable.
Preventive Care for Children Ages 3-10
Continue annual visits starting at age 3 and monitor their growth and development by measuring height, weight, BMI, blood pressure, age-appropriate exams, dental, vision, hearing screenings, and medication reconciliation at each visit.
- Track developmental milestones and school readiness.
- Discuss dental care, obesity, development/behavioral screenings, labs test and screenings as applicable. Immunizations as applicable.
- Use EMR alerts and outreach (texts, calls) to keep families on schedule.
- Counsel on balanced diet, limiting sugary drinks and encourage at least 60 minutes of physical activity daily.
- Counsel on safety guidance by discussing screen time limits, internet safety, car seat booster uses until seat belt fits properly.
Preventive Care for Children Ages 11–19
- Annual Well-Child Visits: Continue yearly checkups to monitor growth, development, and emotional well-being. Measure height, weight, BMI, and blood pressure at each visit.
- Screenings: Include vision, hearing, dental, and mental health screenings. Assess for depression, anxiety, and substance use as appropriate.
- Immunizations: Ensure adolescents receive recommended vaccines such as Tdap, HPV series, meningococcal, and annual flu shots.
- Counseling Topics: Discuss healthy eating, physical activity (at least 60 minutes daily), sleep hygiene, and stress management. Address screen time limits, internet safety, and social media use.
- Risk Reduction: Talk about avoiding tobacco, alcohol, and drugs. Provide guidance on peer pressure, bullying, and safe relationships.
- Sexual Health Education: Offer age-appropriate counseling on puberty, reproductive health, and STI prevention.
- Safety Guidance: Reinforce seat belt use, helmet safety, and driving precautions for teens.
Preventive Care for Adults Ages 20–49
Schedule yearly or biennial visits to monitor overall health, weight, BMI, and blood pressure. Review family history and update medical records.
- Cancer:
- Cervical cancer: Pap smear every 3 years (ages 21–29); Pap + HPV every 5 years (ages 30–49).
- Breast cancer: Begin mammograms at 40 if risk factors; otherwise follow guidelines.
- Colorectal cancer: Begin at 45.
- Mental Health: Screen for depression, anxiety, and substance use.
Immunizations:
- Annual flu shot.
- Tdap booster every 10 years.
- HPV series if not completed.
- COVID-19 and other vaccines per CDC recommendations.
Lifestyle Counseling:
- Encourage balanced diet, portion control, and regular physical activity (150 minutes/week).
- Discuss sleep hygiene, stress management, and screen time limits.
- Address tobacco, alcohol, and drug use; provide cessation resources.
Sexual & Reproductive Health:
- Offer STI screening for sexually active individuals.
- Discuss contraception, family planning, and safe practices.
Safety Guidance:
- Reinforce seat belt use, helmet safety, and workplace ergonomics.
- Counsel on digital safety and mental well-being.
Preventive Care for Adults Ages 50 and Older
Continue annual or biennial checkups to monitor weight, BMI, blood pressure, and overall health and review medications and update family history.
Screenings:
- Blood Pressure: Annually.
- Cholesterol: Every 4–6 years or more often if risk factors exist.
- Diabetes: Screen adults with BMI ≥25 and additional risk factors.
- Cancer:
- Colorectal Cancer: Begin at age 45; continue regular screening (colonoscopy every 10 years or other recommended intervals).
- Breast Cancer: Mammograms every 1–2 years starting at age 50 (or earlier if risk factors).
- Cervical Cancer: Discontinue screening after age 65 if prior tests were normal.
- Prostate Cancer: Discuss PSA testing based on risk and preferences.
- Bone Health: Begin osteoporosis screening (DEXA scan) at age 65 for women and consider earlier for men with risk factors.
- Vision & Hearing: Annual checks.
- Mental Health: Screen for depression, anxiety, and cognitive decline.
Immunizations:
- Annual flu shot.
- Tdap booster every 10 years.
- Shingles vaccine (Shingrix) starting at age 50.
- Pneumococcal vaccines at age 65 or earlier if indicated.
- COVID-19 and other vaccines per CDC recommendations.
Lifestyle Counseling:
- Encourage balanced diet, portion control, and regular physical activity (150 minutes/week).
- Discuss sleep hygiene, stress management, and screen time limits.
- Address tobacco, alcohol, and drug use; provide cessation resources.
Safety & Functional Health:
- Reinforce seat belt use, fall prevention strategies, and home safety.
- Assess mobility, balance, and risk of falls.
- Counsel on digital safety and mental well-being.
Your commitment to preventive care transforms lives. By staying proactive and engaging patients across all age groups, you help detect issues early, promote healthy habits, and build stronger, healthier communities. Every step you take—from scheduling well-child visits to screening for chronic conditions—makes a measurable impact. Let’s continue driving better outcomes together.
- Flu Season
- HEDIS Measures
- CAHPS
- Annual Wellness Visits
- Colorectal Cancer Awareness
- Provider Appointment Standards
- Heart and Nutrition
- Telehealth
- Osteoporosis
- HEDIS/CAHPS Measures: Kidney Health, Eye Exam for Patient with Diabetes, Childhood Immunization Status
- Men's Health Screenings
- Medication Errors: Critical Findings and Critical Interventions
- Understanding How We Grasp Our Members' Experience
- Medallia Program
- Patient Experience Video Series - Video #1
What is CAHPS and HEDIS and Why is the Patient Experience Important to you? - Outpatient Mental Health Survey
- HOS Medicare Health Outcomes
- Patient's Advocacy Program
- Video #2 Where to Start When Focusing on Patient Experience?
- Why Is Patient Engagement Important in Healthcare?
- Maximize the Power of an Annual Preventive Visit.
- World Patient Safety Day: Patient Safety from the Start
- Nurses Drive Meaningful Healthcare Outcomes for Patients
- Monthly CAHPS Tips: Rating of all Health Care Quality
- Monthly HEDIS® Tips: Breast Cancer Screening
- HEDIS Measure: BPD Blood Pressure Control for Patients
- CAHPS Tips: Care Coordination