Sunday, March 27, 2011

Hudson Valley's PCMH

Nearly half a million patients in New York’s Hudson Valley now refer to their primary care physician offices as Patient Centered Medical Homes (PCMH). This was accomplished when the Taconic Health Information Network and Community (THINC) project was able to get six health plans to participate in PCMH.

The six health plans Aetna, CDPHP, Hudson Health Plan, MVP Health Care, UnitedHealthcare, and Empire Blue Cross Blue Shield, represent 65 percent of the commercial insurance market in the Hudson Valley and 43 percent of Medicaid managed care. The health plans paid $1.5 million to 236 primary care physicians in eleven practices to transform to a PCMH and received recognition from the National Committee for Quality Assurance.

Establishing a medical home requires:

• Redesign of the work flow at practices

• Emphasizing a team-based approach to care • Better access to care through open scheduling • Using electronic health communication tools such as EHRs, and ePrescribing

• Practices to initiate care coordination

• Focus on preventive care

The PCMH transformation project was managed over a one year period by THINC, the not-for-profit organization that enables providers, payers, employers, public health agencies, quality organizations, consumers and local leaders to improve the quality safety and efficiency of healthcare for the community. “The success of this project means we’ve reached critical mass for the medical home in the Hudson Valley,” said Susan Stuard, THINC’s Executive Director.

The health plans provided data to evaluate the project’s outcomes as part of a five year commitment to help practices enhance delivery of services. This project evaluation will give information on physician and patient satisfaction and how to make improvements in quality of care. THINC partners will work with researchers at Weill Cornell Medical College to evaluate the outcomes of the program.

Following on the success of the medical home incentive program, THINC in partnership with Taconic IPA and supported by technical expertise from Geisinger Health System is working to bring a model of embedded care management within NCQA Level 3 patient-centered medical homes. Geiginger’s ProvenHealth Navigator program will be tailored to meet the specific needs of the Hudson Valley. The program will start with a small pilot at several sites with the ultimate goal of rolling out to medical homes that are recognized by primary care providers across the community. For more information, go to www.THINC.org or go to www.hudsonvalleyinitiative.com.