On April 1, 2018, the New York State Department of Health (NYSDOH), in partnership with the National Committee for Quality Assurance (NCQA), launched an innovative model for improving primary care and expanding access to high-quality providers, the New York State Patient-Centered Medical Home (NYS PCMH) Recognition Program.
The model was created to unify statewide transformation efforts and achieve the Triple Aim goals of improved health, better consumer experiences and lower costs.
Adirondack Health Institute (AHI) provides expert assistance to practices interested in pursuing NYS PCMH recognition, a designation that signifies a practice has made a strong commitment to quality improvement and a patient-centered approach to care. Because of grant funding, the assistance is no-cost to practices.
AHI’s Jolene Munger, Provider Engagement Manager – Practice Transformation and an NCQA PCMH Certified Content Expert (CCE), provides transformation-related coaching and guidance, and remote and on-site training and support to help practices achieve recognition. Munger worked closely with Mary Nevins, MD, and Abraham Bates, Office Manager, to help Adirondack Pediatrics in Glens Falls achieve 2014 NCQA PCMH Level 3 status, the highest degree of recognition.
The practice had begun pursuing recognition in 2011, but for various reasons got sidetracked and never attained their goal. “We believed in and were already engaging in the principles of the medical home model, placing the patient in the middle of care,” explained Bates, “we just had a lot of balls in the air at the time and it (attaining Level 3 status) fell to the back burner.”
Munger helped the practice get back on track, first reviewing the policies they already in place and explaining program standards to the staff. “We’d get lost and confused over some of the standards because they weren’t written in plain English,” shared Dr. Nevins. “Jolene was able to break it down so we really knew where we stood and what we needed to do.”
According to Bates, Munger reached out to other pediatric practices that had already achieved Level 3 status to ascertain best practices and information she shared with Adirondack Pediatrics. “That was extremely beneficial for us because it helped us know the right steps to take,” said Bates.
The recognition, among other benefits, enhances value-based payment reimbursement opportunities, improves practice efficiency and positively impacts patient care. “Our incentive payments have dramatically increased,” stated Bates.
Before the launch of NYS PCMH, the recognition program covered a three-year timeframe. Now, each practice must apply for recognition annually. “I think it’s going to be much better this way,” stated Dr. Nevins. “This prompts you to keep your standards fresh instead of looking at them every three years.”
If you are a primary care practice interested in pursuing NYS PCMH recognition, please contact Jolene Munger at 518.480.0111, ext. 421, or [email protected]. For more information on the NYS PCMH program, visit AHI’s New York State Patient-Centered Medical Home web page.