NYC PHIP Small Practice Project

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Some 40 percent of primary care providers in New York City are in independent practices with four or fewer health care providers, and they serve some of the city's poorest neighborhoods. But small practices lack the scale to respond to two major trends in health care: the shift toward the medical home, which coordinates all of a patient's health care needs, and the move from fee-for-service to value-based payments that reimburse based on quality of care.

A new, innovative model encourages sharing needed services across a group of small practices, enhancing their ability to serve as medical homes and succeed in value-based payment arrangements.

The New York City Population Health Improvement Program (NYC PHIP) has been working with small practices across New York City and with a group of expert advisors to define and test the viability of this shared-services model.

The final report emerging from this study estimates the costs involved in sharing services, and examines the legal, regulatory, and economic issues related to setting up such a system. This report can serve as a framework for practices considering joining a shared-services organization, and for larger “host” organizations considering initiating such an effort. It includes a distilled checklist of shared services that a host organization might develop to address high-priority needs, which can be tailored to the existing capabilities of participating practices.

A second pdf, also available below, presents an interim qualitative report that documents the focus groups, interviews, and case studies prepared in a preliminary phase of the project.