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. 

Cigna Collaborative Accountable Care - Mt. Kisco Medical Group

Under the program,  Kisco Medical Group, a multi-specialty medical group serving patients in 25 locations throughout Westchester, Putnam and Dutchess counties, monitors and coordinates all aspects of an individual's medical care, both in and out of the hospital. Individuals most likely to see the immediate benefits of the program are those who need help managing chronic conditions, such as diabetes or heart disease. 

To Align or Not to Align: State Options in Multi-Payer Medical Home Initiatives

2014-03-04 15:30 to 17:00

Currently, 19 states are participating in one or more multi-payer patient centered medical home initiatives (PCMH). As states develop new multi-payer PCMH initiatives, they will have to grapple with the question of how much, if any, alignment is necessary among key programmatic elements, including payment, qualification standards and evaluation measures. This webinar, supported by The Commonwealth Fund, will feature key stakeholders from New York, Michigan, and Nebraska who will share their unique approaches that span the alignment spectrum.

Speakers:

Announcement Type: 

New Report Finds Medical Homes Are Reducing Health Care Costs, Utilization, and Improving Health

A review of the year’s academic and industry-generated PCMH evaluations finds significant impact across a number of clinical and financial outcomes.

Embargoed Until Monday, January 13th, 4PM

PCPCC: Michelle Shaljian, 347-754-1692, michelle@pcpcc.net

Milbank: Tara Strome, 212-355-8400, tstrome@milbank.org

New Report Finds Medical Homes Are Reducing Health Care Costs, Utilization, and Improving Health

Rochester Medical Home Initiative (RMHI)

According to a 2012 report from the Primary Care Development Corporation (PCDC), the RMHI is a collaboration between Excellus Blue Cross Blue Shield and MVP Healthcare "who insure a large percentage of the population in the Rochester area, with Excellus covering about 40‐50 percent of the market, and MVP about 20 percent. The two plans developed a medical home demonstration with seven practices covering 33,000 patients.  Excellus and MVP chose to coordinate on quality measures,

Enhanced Personal Health Care Program - New York

The new Enhanced Personal Health Care Program includes an Empire-specific Patient-Centered Primary Care Program, as well as the. This program builds off of a previous WellPoint PCMH pilot (reported outcomes for that pilot were published in a 2012 Health Affairs article) WellPoint's New York patient-centered medical home is a single health plan model. It pays doctors an “enhanced” fee pegged to the achievement of quality levels. The program originated, in part, from the New York City Department of Health’s Primary Care Information Project.

Institute for Family Health PCMH Program

The Institute for Family Health (the Institute) is a network of Federally Qualified Health Centers located throughout New York State, reaching from lower Manhattan in New York City to Ulster County in the Hudson Valley. The network began a process of practice redesign in 2002 with the implementation of an electronic health record (EHR). Additional practice innovations were implemented in the subsequent 9-year period.

Montefiore ACO - CMS Pioneer ACO

The Montefiore Pioneer Model Accountable Care Organization (ACO) is a program that provides certain beneficiaries of the original Medicare program access to enhanced care coordination programs and a focus on illness prevention and wellness.  The Pioneer ACO program is designed to test new models of healthcare delivery and payment and provide Medicare beneficiaries with higher quality care, while reducing expenditures through enhanced care coordination.

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