Health Department, United Hospital Fund and Partners Release Joint Report on Small Primary Care Practices in New York City
Report details a shared-services model for small primary care providers
The Health Department, United Hospital Fund (UHF) and their partners in the Population Health Improvement Program (PHIP) today released a report, The PHIP Small Practice Project, that focuses on the challenges small, independent primary care practices face in New York City. Forty percent of primary care providers in the city are independent practices with four or fewer health care providers, and they serve some of the city’s poorest neighborhoods.
The report is intended to help these providers and their potential partners understand the economics of shared-service arrangements. It describes a business model in which small practices can share the cost of needed services—such as care managers, diabetes educators, and health information technology staff— that can enable them to better care for their patients as medical homes, and reduce preventable hospital admissions and visits to emergency departments. These new capacities can also help small practices to participate effectively in value-based payment arrangements that reward quality and efficiency instead of the volume of services provided.
This shared-services model could enhance New York’s primary care system, which is an essential part of New York State’s health reform initiatives, including the State Health Innovation Plan and the City’s Take Care New York 2020 (TCNY 2020) initiative. These plans help address health inequities, prevent premature deaths, and improve the health of New York City’s residents, especially in communities that face high health disparities. Read the report here.
“Small practices are a critical part of New York City’s primary care system, providing medical services to some of the City’s most disadvantaged and diverse communities, but they are at risk in our changing health care environment,” said Health Commissioner Dr. Mary T. Bassett. “This report describes and quantifies a novel approach—sharing services across small independent practices—that can enable them to access the infrastructure they need to continue to serve those communities.”
“Access to high quality healthcare is important for everyone, no matter who you are or where you live,” said Health Department First Deputy Commissioner Dr. Oxiris Barbot. “Health care providers in small independent practices serve New Yorkers in every community in the city, and this report details supports that can help these small practices succeed in the ever-changing landscape of healthcare reform.”
“The medical home is a promising model to improve primary care delivery, produce better patient outcomes and address health inequities, and New York State is a national leader in the adoption of this model,” said UHF President Anthony Shih, MD, MPH. “This report describes and quantifies a new approach that could help small practices join in this evolution in primary care delivery.”
The report offers New York City's small, independent primary care providers a framework for considering shared services as a way to access the new capabilities and staff they need, but cannot afford, on their own. Shared services also have the potential to improve the sustainability of independent practices, which many New Yorkers rely on for care.
The report covers four topics:
- What small practices need to achieve patient-centered medical home status in which a patient’s treatment is coordinated through the primary care physician to ensure they receive the necessary care when they need it, and to succeed under new value-based payment arrangements.
- How some organizations across the State are providing a range of services to groups of small primary care practices.
- What a fully-developed shared-service program might look like, the range of services that it might include, and the related costs.
- The legal and regulatory issues providers need to consider in crafting shared-services arrangements.
Over the past 18 months, PHIP has worked with small practices across New York City to better understand their needs and assess the viability of a shared-services model, with a focus on the new skills required. The potential costs and value of such arrangements were also calculated.
Launched in 2015, Take Care New York 2020 (PDF) is the City’s blueprint for giving every New Yorker the chance to live a healthier life. Its goal is twofold – to improve every community’s health, and to make greater strides in groups with the worst health outcomes, so that the City becomes a more equitable place for everyone. TCNY 2020 aims to promote healthy childhoods, create healthier neighborhoods, support healthy living, and increase access for quality care.
In January 2015, the Fund for Public Health in New York joined in partnership with the New York City Department of Health and Mental Hygiene, United Hospital Fund, and The New York Academy of Medicine to launch the New York City Population Health Improvement Program (PHIP). The NYC PHIP is one of 11 PHIPs created around the state, with funding from the State Department of Health, working to achieve inclusive health planning at the regional and local level. The PHIP will promote health equity for New Yorkers, as well as the “Triple Aim” of better care, lower health care costs, and better health outcomes.
United Hospital Fund works to build a more effective health care system for every New Yorker. As an independent, nonprofit organization, UHF analyzes public policy to inform decision-makers, find common ground among diverse stakeholders, and develop and support innovative programs that improve the quality, accessibility, affordability, and experience of patient care. For more information about UHF’s initiatives and programs click here.
Resources for family caregivers and health care providers are available at our Next Step in Care website.