A Mission-Driven Accountable Care Organization (ACO)

Continuing Medical Education (CME) Modules

Chronic Disease Management

  • Protected: Demystifying Hepatitis C: Empowering Primary Care Providers

    Protected: Demystifying Hepatitis C: Empowering Primary Care Providers

    In this course, the team of instructors identify Hepatitis C as a public health issue and describe screening guidelines and diagnostic criteria. They make recommendations for treatment for chronic hepatitis C, directing when to refer to specialists, as well as review sample HCV treatment protocol for primary care settings.
    Presented by:
    Kristene Welch, Nicki Iozzia, and Allison White
  • Protected: Heart Failure – Increasing GDMT Use in HFrEF

    Protected: Heart Failure – Increasing GDMT Use in HFrEF

    Dr. Clifford reviews the recommended treatment for heart failure in the primary care setting using GDMT therapies. He encourages staff to increase the medically appropriate use of evidence supported GDMT in order to achieve lower mortality and hospital rates. This module is focused on highlighting the most current rigorous guideline supported treatments.
    Presented by:
    Tim Clifford, MD
  • Protected: Heart Failure – Increasing Use of GDMT for HFrEF

    Protected: Heart Failure – Increasing Use of GDMT for HFrEF

    In this course, Dr. Tim Clifford reviews the four GDMT pillars of HFrEF therapy, why it is important, and what the value is to adding all four drugs to a patient’s routine. He reviews the best evidence based treatments and how patients can benefit from this additional treatment plan.
    Presented by:
    Tim Clifford, MD
  • Protected: Heart Failure Management

    Protected: Heart Failure Management

    Dr. Jims Jean-Jacques reviews the published guideline updates for emerging therapies in heart failure and summarizes the appropriate uses of heart failure pharmacotherapeutics. He discusses the importance of collaborative strategies and multidisciplinary teams as well as the importance of addressing non-cardiac morbidities.
    Presented by:
    Jims Jean-Jacques, MD
  • Protected: Hypertension Management: Primary Care Essentials

    Protected: Hypertension Management: Primary Care Essentials

    In this course, Tim Clifford, MD & Michela Fiori, PharmD compare and contrast hypertension definitions and blood pressure targets, and apply appropriate classification criteria to clinical decision-making. They also provide insight into managing hypertension using evidence-based strategies including combination therapy, adherence assessment and more in a primary care setting.
    Presented by:
    Dr. Tim Clifford & Michela Fiori, PharmD
  • Protected: The Emotional Pain of Pain

    Protected: The Emotional Pain of Pain

    In this course, Colleen Owens broadens the lens on how pain is viewed, expanding the participants’ understanding of the impact of pain on the patient, family, friends, and providers. This course also covers the bias and its impact on treatment as well as different ways to discuss pain and pain treatment.
    Presented by:
    Coleen Owens, LCPC

Controlled Substance Stewardship

  • Protected: Benzodiazepine Use

    Protected: Benzodiazepine Use

    In this course, Dr. Trip Gardner reviews the history of benzodiazepine use, the effects, the risks, and how to reduce the use of them.
    Presented by:
    Trip Gardner, MD
  • Protected: Buprenorphine for Chronic Pain

    Protected: Buprenorphine for Chronic Pain

    In this course, Dr. Nesin provides information on the options for providing Buprenorphine to patients with chronic pain that currently use opioids for treatment. This course is to ensure that the patients are receiving safe care with the best options.
    Presented by:
    Noah Nesin, MD
  • Protected: Naloxone for Opioid Overdose

    Protected: Naloxone for Opioid Overdose

    In this course, Courtney Perry reviews the signs of an overdose as well what to do in the case of an overdose. In addition, she explains how Naloxone works and how to administer Naloxone.
    Presented by:
    Courtney Perry, PharmD
  • Protected: Opioid Education Series – Urine Drug Screening

    Protected: Opioid Education Series – Urine Drug Screening

    In this short course, Eva Quirion teaches participants the rationale for performing urine drug screenings for patients receiving controlled medications and the difference between qualitative and quantitative tests. After attending, the participants will also be able to determine the next steps when urine drug screening reveals unexpected results.
    Presented by:
    Eva Quirion
  • Protected: Opioid Prescribing for Orthopedic Injuries

    Protected: Opioid Prescribing for Orthopedic Injuries

    In this course, Dr. Nesin, Dr. Truelove and Dr. Tsismenakis cover the relationship between pre-operative and post-operative opioid use and patient outcomes. In addition, they identify evidence-based pain management strategies and apply opioid prescribing guidelines.
    Presented by:
    Noah Nesin, Elizabeth Truelove, and Tony Tsismenakis
  • Protected: Pain, Opioids and Suicidality

    Protected: Pain, Opioids and Suicidality

    Dr. Noah Nesin provides insight into how to evaluate the links between opioid use, chronic pain, suicide, and the subsequent impact on patient care. In addition, he covers prevention strategies for unintentional opioid overdose and suicide and shares knowledge on the principles of ethical and compassionate opioid tapering aimed at reducing unintentional overdose and suicide.
    Presented by:
    Noah Nesin, MD
  • Protected: Universal Screening for SUD

    Protected: Universal Screening for SUD

    In Part 1 of this course, Dr. Nesin provides evidence supporting universal screening for substance use in the primary care setting as well as reviews validated tools for screening. He explains the challenges in implementation of universal screening and teaches about strategies to mitigate said challenges to help ensure success.
    Presented by:
    Noah Nesin, MD

Operation HCC

  • Protected: Condensed Operation HCC

    Protected: Condensed Operation HCC

    In this condensed course, Dr. Tim Clifford reviews commonly missed HCC codes, including four chronic conditions to focus on, as well as how to better recognize these codes in patients.
    Presented by:
    Tim Clifford, MD
  • Protected: Operation HCC

    Protected: Operation HCC

    In this course, Dr. Tim Clifford explains what HCC code and risk adjustment is and why it matters. In addition, he covers the most commonly missed HCC codes and how to better recognize and capture these diagnoses.
    Presented by:
    Tim Clifford, MD
  • Protected: Operation HCC 2025 – 2026

    Protected: Operation HCC 2025 – 2026

    In this course, Dr. Tim Clifford reviews the most prevalent but missed HCC codes, including chronic conditions to focus on, as well as how to better recognize these codes in patients.
    Presented by:
    Dr. Tim Clifford
  • Protected: Operation HCC for Behavioral Health Providers

    Protected: Operation HCC for Behavioral Health Providers

    In this course, Dr. Clifford identifies commonly mis-coded conditions and how to better capture these diagnoses for behavioral health providers.
    Presented by:
    Tim Clifford, MD
  • Protected: Operation HCC for Walk In Care, Urgent Care and Emergency Department Providers

    Protected: Operation HCC for Walk In Care, Urgent Care and Emergency Department Providers

    In this course, Dr. Clifford identifies commonly mis-coded conditions and how to better capture these diagnoses for walk in care, urgent care, and emergency department providers.
    Presented by:
    Tim Clifford, MD

Other

  • Protected: Addressing Bipolar Disorder in the Primary Care Setting

    Protected: Addressing Bipolar Disorder in the Primary Care Setting

    In this course, Dr. Trip Gardner covers how to address bipolar disorder in the primary care setting, including the epidemiology of the disorder, identifying, assessing and treating patients. After this course, providers should understand the relationship between bipolar disorder and suicide, including risk factors and protective factors.
    Presented by:
    Trip Gardner, MD
  • Protected: Chronic Care Management Billing

    Protected: Chronic Care Management Billing

    Susan Whittaker and Sharon Stanley use this course to explain Chronic Care Management Services (CCM) and why it is important, as well as how to bill for the service and the required elements of documentation.
    Presented by:
    Susan Whittaker & Sharon Stanley
  • Protected: Communication and De-escalation

    Protected: Communication and De-escalation

    In this course, Wallace Fraser teaches participants to understand and practice active listening, understand underlying causes of escalated behavior, and how to understand and practice techniques to better manage escalated patients.
    Presented by:
    Wallace Fraser, LCPC
  • Protected: Introduction to Clinical AI: Using OpenEvidence for Evidence-Based Practice

    Protected: Introduction to Clinical AI: Using OpenEvidence for Evidence-Based Practice

    In this course, Tim Clifford, MD introduces the fundamentals of clinical AI and demonstrates how to use OpenEvidence as a clinical decision support tool in primary care, using real hypertension and atypical pneumonia cases. Participants learn how clinical AI differs from general AI tools, how to structure effective PICO-based queries, recognize AI limitations such as hallucinations versus incorrect responses, and apply privacy best practices to avoid PHI/PII while integrating AI safely into everyday clinical workflows.
    Presented by:
    Tim Clifford, MD
  • Protected: Oral Therapy Prescribing for COVID-19

    Protected: Oral Therapy Prescribing for COVID-19

    In this course, Dr. Aaron Karmes familiarizes the current COVID outpatient therapeutic options as well as how to safely prescribe both Paxlovid and Molnupiravir.