Clinical Connections December 2021

Dear Clinical Providers and Colleagues,

Holiday greetings! We’re pleased to share exciting new programs coming in 2022, as well as articles and HEDIS Performance updates, added to our Provider Portal.

Please read and pass on this newsletter to staff and if this was forwarded to you, take a minute to subscribe to Clinical Connections here. As always, we welcome your feedback on what you want to hear from WHA. Email me at

Khuram Arif M.D., MBA, CPE
Chief Medical Officer, Western Health Advantage

Program Highlights

Look for details on these exciting NEW programs coming in 2022:

Nutritional Counseling — WHA is pleased to be first in our area to dramatically expand coverage for nutrition and dietary counselling. Designed in conjunction with WHA doctors, this benefit meets an urgent need for members struggling with weight-related illness whether obesity, eating disorder or weight loss secondary to illness. Clinical providers may refer patients to Dieticians or Nutritionists for:

  • Initial treatments of 3-6 visits based on member’s condition, with additional visits based on demonstrated improvement
  • Patients diagnosed with specific eating disorders will be allowed up to 18 visits initially and then as medically necessary 
  • Services require prior authorization. For more information, see our webpage.
  • Available starting in January 2022 for small and large group members

Livongo for Hypertension* through Teladoc — Livongo incorporates a suite of tools including a connected blood pressure monitor, real-time insights after each reading, health education, and one-on-one support from expert coaches.

  • Expected in February for employer group members over the age of 18 living with hypertension. Details to follow.
  • Members will access Livongo’s wireless, mobile, and web-based hypertension web portal. 

Kaia Musculoskeletal Pain Management Program* — Coming in early 2022, an innovative partnership with Kaia from Optum Health, a proven MSK solution that combines human care with superior technology to achieve better outcomes. Kaia, a global market leader in motion tracking using your smartphone, brings an alternative to surgery or pain medication.  Early results show a 40% decrease in participant pain level and a 58% increase in sleep. Details coming soon!

*Pending DMHC approval

News to Take Note

Article: NCQA’s Multicultural Health Care Distinction. WHA needs your help to pass this survey next year to help meet health equity needs for your patients. Recently WHA shared its annual Cultural and Linguistics Report detailing medical group performance and resources to ensure cultural competence. Read about our Language Assistance Program at WHA’s secure Provider Portal. Here are ways you can help:

  • Ensure patient demographics are captured in the eHR at every patient interaction
  • Provide your own Race/Ethnicity/Language information for WHA’s Provider Directory

Article: After Hours Access, Triage & Screening Guidelines. Health plans are required by the Department of Managed Health Care’s (DMHC) Timely Access Regulations to assess after-hours access, triage and/or screening in their provider networks. Health plans must ensure that after-hours triage and screening are offered within specified timeframes, in a manner appropriate for the nature of the patient’s condition.

Article: Vaping. Please review guidance to clinical providers about e-cigarettes and vaping.

HEDIS Measures 2020

We’ve updated our HEDIS measures for 2020. Take a minute to read through updates at our new HEDIS Performance webpage. You’ll find articles on the following topics:


WHA’s Clinical Provider Handbook is now available for our providers as your single source of WHA policies and procedures. 

Patients nearing age 65? Invite them to WHA’s “Get to know Medicare” online seminars. They’ll get valuable information on the parts of Medicare, key eligibility information, and dates. Pass on this flyer to those aging-in patients (and current Medicare beneficiary patients). All of our plan information, webinar schedule and resources are on our WHA MyCare Medical Advantage (HMO) plans webpage.

Your Patients with Diabetes may take part in our Virta program and we’re seeing great results among WHA members. Please look for updates and flyers from WHA’s Provider Portal.

If you have been affected by a natural disaster, we're here to help: See Emergency Resources