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Medicaid Changes: What is changing and what should you do?

Medicaid Changes: What is changing and what should you do?

Most people will get the same Medicaid services in a new way – through health plans. You will be able to choose the health plan that is best for you. You will also choose a primary care provider (PCP).

Download/Print Managed Medicaid Information Sheet >

North Carolina’s Medicaid program changed to Medicaid Managed Care on July 1, 2021. This means that most Medicaid beneficiaries will receive their benefits through health plans (similar to private insurance) for the first time instead of directly from the state. A health plan provides a network of doctors, hospitals, and other providers who work together to provide the care you need.

Most Medicare recipients will have to enroll in a specific plan in order to receive their benefits. You should have received information from Medicare about enrolling in a plan in March of 2021. If you did not enroll in a plan by May 21, 2021, you were automatically enrolled in one.

Appalachian Regional Healthcare System (ARHS) will be “in-network” for the AmeriHealth plan, and possibly others. All health plans offer the same basic Medicaid services. Each health plan has its own network of providers. You can sign up for a new plan and select a new primary care provider that is “in-network” for ARHS, or for any reason, within 90 days of your initial enrollment date or until September 30.

 

What you need to do

  1. Choose a primary care provider (PCP): To keep your doctor, clinic or other health care provider as your PCP, find out which health plans they work with. You can also choose a new PCP.
  2. Choose a health plan: A health plan is a group of doctors, hospitals and other providers. They work together to give you the health care you need. ARHS will be in-network with AmeriHealth. Learn more: ncmedicaidplans.gov/find/viewhealthplans
  3. Enroll in one of these ways:
    • Go to ncmedicaidplans.gov
    • Use the NC Medicaid Managed Care mobile app
    • Call us toll free at 1-833-870-5500 (TTY: 1-833-870-5588)
    • When you receive an enrollment form, fill it out and mail or fax it back

 

Questions?

Contact NC Medicaid directly with questions about eligibility, coverage, or enrolling in a plan. Visit ncmedicaidplans.gov or call 1-833-870-5500 Monday through Saturday between 7 a.m. and 5 p.m.

If you are staying with the traditional Medicaid plan and have questions, contact your Medicaid Case Manager at the following locations and numbers:

  • Watauga DSS 828-265-8100
  • Ashe DSS 336-846-5719
  • Avery DSS 828-733-823
Updated ARHS COVID-19 Visitor Guidelines

Updated ARHS COVID-19 Visitor Guidelines

ALERT: Please do not bring children under the age of 18 to visit hospitals or healthcare facilities. For their safety, please do not leave children unattended on ARHS property, including inside cars. 

Updated: September 9, 2021

Masks are still required inside ARHS patient care areas

We know that many of our patients are happy to see a decline in COVID-19 infections in our community and were excited to hear the CDC’s recent mask updates. However, the new CDC guidance states that certain settings would still require masks and other safety measures.

Everyone, including individuals who are fully vaccinated, are still required to wear a mask in healthcare settings such as hospitals and doctor’s offices. As ARHS continues to follow CDC guidelines, all patients and visitors are required to wear a face mask over the mouth and nose, during their visit to any of our facilities.

 

General COVID-19 Visitor Guidelines

At Hospitals, Outpatient Offices and other ARHS Locations, visitors must:

  • Wear a mask that covers their nose and mouth at all times (except while eating in select areas).
  • Have a health screening check when they enter the building.
  • Be at least 18 years old.
  • Be in good health (free from respiratory illness, fever, cough, etc.).
  • Stay in the patient room visiting the patient, they cannot roam the hospital.
  • Follow all social distancing and safety guidance. This includes wearing masks, staying six feet from others and hand washing.
  • If a visitor does not follow the guidance above, it can cause serious safety concerns. They will be escorted out of the building in order to keep our patients and staff safe.
  • Special circumstances will be managed by the House Supervisor or Practice Manager.
  • Visitors may NOT enter If they have COVID-19 or are waiting on COVID-19 test results.

 

Watauga Medical Center & Cannon Memorial Hospital

Adult Patients
Visiting hours are 7:00 a.m. to 8:00 p.m. Two (2) visitors will be allowed for adult patients at any given time. Each room will have two visitor badges, which must be worn by visitors at all times. Visitors may change throughout the day and may leave the facility and return during the same day. If both badges are checked out from a room, additional visitors may not enter.

Patients having surgery may have one (1) visitor with them until they are in their patient room, even if they arrive before 7:00 a.m. Once they are in their patient room, they may have up to two (2) visitors from 7:00 a.m. to 8:00 p.m.

Pediatric Patients
Patients under 18 may have two (2) parents or guardians visit any time of day, however these visitors may not change and must remain the same throughout hospitalization. This is to minimize any risks to newborns and to allow for rapid tracking should a COVID infection occur.

 

WMC Birthing Center

Laboring patients may have two (2) designated visitors, which may not change and must remain the same throughout hospitalization. After the birth of the baby, only one (1) designated overnight visitor may stay. The second visitor may return at 7:00 am and must leave by 8:00 pm. A doula will be considered the second visitor.

 

Emergency Departments

Emergency Departments patients are allowed one (1) visitor any time of day, unless otherwise approved by the clinical team. Two (2) parents or guardians are allowed if patients are under 18. Visitors must wear a badge with the room number identified.

If the Emergency Department is busy, visitors will not be allowed in waiting rooms. Visitors will have to remain outside the Emergency Department (in their vehicle) until the patient is placed in a room.

Exceptions will be managed by the ED Charge Nurse.

 

Inpatient Behavioral Health

Visiting hours are 3:00 p.m. to 9:00 p.m. One (1) visitor will be allowed for a period of 30 minutes, by appointment only. Potential visitors should call (828) 737-7000 to schedule an appointment.

 

Medical Practices/Doctor’s Offices

One (1) visitor will be allowed to come to doctor visits with adult patients. Two (2) parents or guardians are allowed to come to visits if patients are under 18.

For special situations, the Provider will work with the office manager to find the best solution for the patient.
Patients and/or Visitors may be asked or choose to wait in their vehicles and be called on their cell phones when a room is ready if space is limited or they do not wish to wait in the public area.

 

End of Life Situations

Patients with COVID-19 (End-of-Life Situations)

  • One (1) visitor is allowed during end-of-life situations. Otherwise, visitors are not allowed.
  • Visitors must wear a gown, gloves and a surgical mask.
  • Physician and House Supervisor will determine what is considered “end of life”

Non-COVID-19 Patients (End-of-Life Situations)

  • End-of-Life visitation will be considered and approved on a case-by-case request and need.
  • Visitors must wear a surgical mask.
  • There are no visitation time limits.
ARHS names Schaefer Family Patient Care Tower in honor of lead gift

ARHS names Schaefer Family Patient Care Tower in honor of lead gift

Photo: WMC Hospital Expansion Exterior_SchaeferName_1200x675

June 10, 2021

Many things come to mind when the names Bonnie and Jamie Schaefer are spoken – savvy business acumen, dedication to their faith community, as well as support for the arts, women’s causes, animal welfare, higher education and more. Especially in the High Country, the Schaefer family name evokes gratitude for the incredible philanthropy, support and wisdom they give to their community.

The Schaefers have been great friends to Appalachian Regional Healthcare System (ARHS) throughout the years. They both recently experienced significant health challenges and turned to ARHS to walk with them through their journey of healing.

For a total of 70 days and nights over the last two years, Bonnie and Jamie considered the hospitalists, doctors and nurses at Watauga Medical Center to be their extended family, describing them as “our angels with invisible wings who provided comfort and care on a daily basis.”

While the Schaefers have the means and opportunity to seek healthcare from anywhere in the world, they trusted Appalachian Regional Healthcare System with life-saving medical care, chronic disease management, surgical services, emergency care, intensive care — as well as several other service lines and specialists. Fortunately, they are both on the road to good health and they only return to the hospital for routine care these days.

But while they were in the hospital, they realized that the world-class healthcare they received from the people of Watauga Medical Center didn’t necessarily match the aging physical building.

Photo: Steve Weishoff, Jamie and Bonnie Schaefer, Marla Schaefer

Left to Right: Steve Weishoff, Jamie and Bonnie Schaefer, Marla Schaefer

“They say people make a place and it’s a good thing, because the core hospital, built in 1967, is dated, in disrepair and in need of improvement,” said Bonnie.

“Watauga Medical Center offers life-saving medical care to those living in the High Country,” said Jamie. “The patients and healthcare professionals need and deserve a new, state-of-the-art hospital.”

The couple recently returned to the hospital – their “home away from home” – to thank the hospital family, including doctors, nurses, dietary staff, lab technicians, cleaning staff, and the chaplain.

And in a tradition as long-standing as the Schaefer family itself, they are taking steps to ensure that everyone continues to receive the same high standard of care they did – for generations to come – in a brand new, modern patient care tower.

Bonnie and Jamie are joining together with their family, Marla Schaefer and Steve Weishoff, to give a three-million-dollar gift for the future Schaefer Family Patient Care Tower at Watauga Medical Center.

“I would like to thank Bonnie and Jamie Schaefer, Marla Schaefer and Steve Weishoff for their generosity in providing the lead gift for a new 48-bed hospital tower,” said Rob Hudspeth, President of the Appalachian Regional Healthcare Foundation and Sr. Vice President for System Advancement for ARHS. “This historic investment will fuel the future of healthcare in the High Country, ensure access to continued technological improvements and allow us to reimagine our community hospital to address the ever-changing world of healthcare.

To learn more about the hospital expansion project, visit apprhs.org/wmc-expansion/. For more information about the Appalachian Regional Healthcare Foundation, visit apprhs.org/foundation.

 

Advanced radiation therapy technique implemented at Seby B. Jones Regional Cancer Center

Advanced radiation therapy technique implemented at Seby B. Jones Regional Cancer Center

Photo: SBRT Machine

May 5, 2021

Watauga Medical Center announced today that Seby B. Jones Regional Cancer Center (the Cancer Center) has implemented Stereotactic Body Radiation Therapy (SBRT) to treat cancerous tumors. Typically only available at larger centers, SBRT is an advanced technique that precisely targets a high dose of radiation directly to cancer cells.

When a tumor is located in the torso, the patient’s breathing causes it to move, making it difficult to precisely target with traditional radiation therapy.

Radiation oncologists at the Cancer Center use 4D imaging technology to determine the exact size, shape and location of the patient’s tumor and to map where the tumor moves throughout the breathing cycle. Using this “roadmap,” SBRT radiation is delivered to the tumor with pinpoint accuracy, while simultaneously avoiding damage to the patient’s surrounding healthy tissues.

Photo: Monitoring patient during SBRT SBRT involves the entire treatment team. A radiation therapist, physicist, and doctor are all present during sessions to monitor the patient, making sure the tumor doesn’t move outside the treatment area during breathing.

“Traditional radiation therapy is delivered daily in small doses for six to eight weeks, and can delay additional treatment therapies,” said Ken Neuvirth, Senior Director of Oncology for Appalachian Regional Healthcare System. “SBRT allows us to treat patients in fewer sessions which leads to fewer side effects and better outcomes.”

Small metastatic tumors or early stage primary cancers are the best candidates for this therapy. For example, a patient in the ARHS lung cancer screening program who discovers their cancer in stage one or two might choose this treatment over surgery. For cancer patients who cannot undergo surgery, SBRT offers a safe and effective option.

Having SBRT technology in Boone means that more patients will be able to receive the cancer treatment they need closer to home. They will not have to make expensive housing arrangements in a larger city while they complete their treatment, and they can be surrounded by family, churches, or other support systems.

The Seby B. Jones Regional Cancer Center first received the American College of Surgeons’ Commission on Cancer® Accreditation in 1997 and reaccredited in 2019.

Learn more about Watauga Medical Center’s cancer services at apprhs.org/cancer/.

Learn more about the Seby B. Jones Regional Cancer Center at apprhs.org/cancercenter/.

ARHS provides real-time  notifications for community providers through PatientPing

ARHS provides real-time notifications for community providers through PatientPing

April 30, 2021

Patient Ping Notifications PatientPing is a care collaboration software that provides real-time visibility into patient care events across the continuum. Working with hospitals, post-acutes, health plans, ACO’s and beyond, the platform connects providers across the nation to improve patient and organizational outcomes.

Appalachian Regional Healthcare System (ARHS) has partnered with PatientPing to provide real-time e-notifications upon patient admit, discharge, and transfer events at to community providers in accordance with the Centers for Medicare and Medicaid Services (CMS) requirements  (e-notifications CoP). Community providers will be able access event notifications from ARHS in two different ways:

PingDirect
Notifications will be sent to PCPs and other providers identified by the patient and recorded in their patient record during a hospital encounter via Direct Messages, a national encryption standard for secure clinical data exchange. Providers will have the option to unsubscribe from receiving Direct Messages via a link in the e-notification if they wish.

PingPortal
Primary care entities, PACs, and other providers can also proactively request and receive notifications on their attributed patients at no cost by submitting a patient roster either directly or through a PAC EHR integration. Providers will be able to select from flexible notification delivery options to suit their workflows including web application, SMS/email push alerts, and data downloads.

To sign up for event notifications for their patients, providers may register with Patient Ping. Once you have submitted your information, a PatientPing representative will contact you directly to assist you in enabling real-time, e-notifications from ARHS.

Community providers can always access the PatientPing registration on the “Referring a Patient” web page at apprhs.org/refer. 

Photo Gallery: Our COVID-19 Journey

Photo Gallery: Our COVID-19 Journey

Image: Thank You Healthcare Team Taking care of patients
Keeping our facilities clean
Providing COVID testing
Offering Telehealth appointments
Getting vaccinated
Vaccinating the community

We make life better for our community!

Click any photo to view the slideshow