New York

New York State has been a national leader in medical home activity and currently has the largest number of regional, multi-payer PCMH initiatives. In 2009, the New York State Assembly authorized two medical home demonstration projects - a multi-payer Medical Home Demonstration in the Adirondack region and a statewide Medicaid PCMH demonstration. In July 2010, Article 5, Title 11 of the New York State Social Services Law, Section 364-m gave the Commissioner of Health the authority to establish a Statewide PCMH program whereby providers who are recognized by the NCQA are eligible to receive additional payments for services provided to Medicaid FFS and managed care enrollees. Preliminary analyses conducted by the NYSDOH indicate that MMC enrollees assigned to a provider within a PCMH have higher quality of care and outcomes as defined by standardized measures of quality. In addition, clinical areas where PCMH providers were initially underperforming such as appropriate antibiotic prescribing, have improved from 2010 to 2011. The Commissioner of Health has the authority to continue the Adirondack program until March 31, 2014. A recent budget request will extend the statewide program until March 31, 2016. 

CHIPRA: 
No
MAPCP: 
Yes
Dual Eligible: 
Yes
2703 Health Home: 
Yes
CPCi: 
Yes
SIM Awards: 
Yes
PCMH in QHP: 
No
Legislative PCMH Initiative: 
Yes
Private Payer Program: 
Yes
State Facts: 
Population:
19,518,100
Uninsured Population:
9%
Total Medicaid Spending FY 2013: 
$54.4 Billion 
Overweight/Obese Adults:
61.3%
Poor Mental Health among Adults: 
35.1%
Medicaid Expansion: 
Yes 
CPC+: 
CPC+
Investment Description: 
New Yorks's legislation was vetoed. 

Shifting Motivations: Rethinking Primary Care Physician Incentives In Health IT Implementation

Clinician adoption and implementation of health information technology (IT) has increased significantly since the passage of the HITECH Act in 2009. Dedicated efforts and large financial incentives have spurred innovation and motivated progress in many aspects of information technology, including information exchange and community-level health IT implementation. Yet poor usability of systems and overwhelming reporting burden still present barriers to optimal use of health IT.

News Author: 
Leah Marcotte

Primary Care Milestone Reached by 99% of Sites; H-MH Funding to Proceed

The second year of funding for the New York State Hospital-Medical Home (H-MH) Demonstration will proceed because a key performance milestone has been achieved, the Department of Health (DOH) announced during a conference call with HANYS on Thursday. The H-MH Demonstration is a healthcare quality and safety improvement program for Medicaid services in New York State.

Aetna medical home already paying off

A regional patient-centered medical home demonstration is appears to be prime for expansion of Medicare members. Last year, Aetna started a PCMH program with WESTMED Medical Group, a physician-owned and managed multi-specialty group in greater New York City’s Westchester County and now, after some promising the results, the arrangement will be extended to include a Medicare collaborative care contract.

News Author: 
Anthony Brino

First-of-its-kind PCMH study: Hudson Valley medical homes outperform peer practices using paper-based or electronic health records

Research shows it's not about the technology--it's about the medical home culture

In a novel approach to test the merits of the patient-centered medical home model, research published today in the Annals of Internal Medicine concludes these practices improve care quality at a significantly higher rate than their non-PCMH peers—regardless of whether the comparison practices used paper or electronic health records. The three-year study also found the odds of patients receiving recommended care over time in the medical home were considerably higher.

Patients advise doctors on ways to reform medical practice

The patients have spoken, and they want better and easier communication with their doctors. At CapitalCare Medical Group, patients have told managers they want to talk to a person, not navigate a machine's menu, when they call the office. But they also want to leave a detailed message about symptoms or request a prescription refill at odd times of night. And they could use a brochure with a list of services, as well as the direct phone numbers of the people who can answer questions.

News Author: 
Claire Hughes

Hospital-Medical Home (H-MH) Demonstration Program

The Hospital Medical Home program is part of New York's 1115 Medicaid waiver and one of the Medicaid Redesign Team (MRT) initiatives. The purpose of this demonstration is to improve the coordination, continuity, and quality of care for individuals receiving primary care in hospital outpatient departments operated by teaching hospitals, as well as other primary care settings used by teaching hospitals to train resident physicians. The demonstration will be instrumental in influencing the next generation of practitioners in the important concepts of patient- centered medical homes.

Medicaid Redesign Team (MRT) reforms

On April 14, 2014, Governor Andrew M. Cuomo announced that New York has finalized terms and conditions with the federal government for a groundbreaking waiver that will allow the state to reinvest $8 billion in federal savings generated by Medicaid Redesign Team (MRT) reforms. The MRT waiver amendment will transform the state's health care system, bend the Medicaid cost curve, and ensure access to quality care for all Medicaid members.

Fully Integrated Dual Advantage (FIDA)

New York signed a Memorandum of Understanding with CMS on 8/23/2013. The New York demonstration targets dual eligible beneficiaries age 21 and older in 8 counties who are eligible for a nursing home level of care and receiving facility-based LTSS or who are eligible for the nursing home transition and diversion 1915(c) waiver or who require community-based LTSS for more than 120 days.

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