A new Primary Care transformation model is spreading in New York State that holds promise for improving outcomes and patient experience. Technical assistance will help practices develop capacity to provide more comprehensive, coordinated care, and payers will reward superior performance on quality measures.

Supported by a contract from the New York State Department of Health (Health Research Incorporated)

Advanced primary care incentivizes quality and value. This comprehensive, coordinated approach to patient care focuses on prevention and improved disease management. It also supports superior performance on quality measures, rather than volume of services delivered, with enhanced payment.

In partnership with the New York State Department of Health (DOH), UHF’s Quality Institute is helping formulate strategies to implement and oversee quality measurement, performance monitoring, and reporting that will support improvements in primary care practices. This work is part of a major four-year transformation initiative in New York State funded by the Centers for Medicare & Medicaid Services through a State Innovation Models (SIM) grant.

ACTIVITIES AND OUTCOMES

Since the launch of the SIM Initiative in 2015, the Quality Institute:

  • Has helped develop and vet a single, parsimonious, and nationally endorsed set of meaningful quality measures that could be used to assess the performance of participating primary care practices. As part of a State-appointed multi-stakeholder workgroup of DOH team members, payers, purchasers, providers, and consumers, we helped shape consensus on this valid and reliable core set of measures, covering six domains:
    • Prevention
    • Chronic disease
    • Behavioral health/substance abuse
    • Patient-reported outcomes
    • Appropriate use of services
    • Cost
  • Is working with a team of DOH leaders, staff, and contractors on steps to implement the core measure set for quality measurement and performance reporting, as an interim step until New York State’s All-Payer Database (APD) is operational;
  • Has curated a collection of evidence-based quality improvement tools and resources that primary care practices can use to assess and improve performance related to the six health care domains.

LOOKING AHEAD
Our work with DOH on transforming primary care continues, with activities focused on:

  • Supporting the work of DOH Practice Transformation Agents, i.e., technical assistance contractors who are charged with helping primary care practices meet the expectations of the  program and use quality measurement and monitoring to improve quality of care and health outcomes for patients;
  • Helping develop a framework for oversight of Primary Care quality measurement, monitoring, and improvement in New York, through new state and regional entities created by DOH. The Quality Institute will advise and help support the stewardship role and quality oversight functions of a new Statewide Steering Committee (SSC), as well as the efforts of new Regional and Oversight Management Committees (ROMCs) as they develop regional approaches for measuring and improving quality and paying for performance;
  • Advising DOH on ways to incorporate the patient experience in quality measurement for the  program.

Contact: Anne-Marie Audet, Lynn Rogut