Primary Care Model Seen as Key to Health Care Payment Reform
New York, N.Y., March 29, 2016 – Thanks to expert assistance and coaching from the Primary Care Development Corporation (PCDC), 200 primary care practices have now achieved National Committee for Quality Assurance (NCQA) patient-centered medical home (PCMH) recognition.
In the PCMH model, primary care practices are responsible for providing and coordinating high-quality, patient-centered care for their patients. It is a key element of health care payment reform currently underway in Medicaid, Medicare and commercial health plans, and is often linked to financial incentives for providers. For instance, New York State’s Delivery System Reform Incentive Payment program (DSRIP) requires all participating primary care providers to achieve the highest level of PCMH recognition. PCDC is currently helping dozens of practices toward this goal and is working with key stakeholders to expand access to high quality primary care in underserved communities throughout the state.
“PCDC’s mission is to ensure access to quality primary care for every family in every community,” said PCDC CEO Louise Cohen. “The medical home model is widely accepted as how primary care should be organized and delivered – and I am proud that we have now helped 200 practices provide more coordinated, patient-centered care to hundreds of thousands of patients.”
PCDC’s two most recent practices were Mount Sinai Doctors Faculty Practice locations in Harlem and near Columbus Circle in Manhattan. The busy multispecialty practices serve more than 13,000 patients each year, including more than 1,300 Medicaid enrollees. Both practices, which were previously recognized under NCQA’s 2011 standards, earned PCMH Level 3 recognition (the highest level) under NCQA’s more challenging current criteria. PCDC is also helping 13 additional Mount Sinai practices achieve PCMH recognition.
“The medical home model is essential to Mount Sinai’s strategy of transforming how health care is delivered in the communities we serve,” said Burton Drayer, MD, CEO, Mount Sinai Doctors Faculty Practice and Dean for Clinical Affairs, Icahn School of Medicine at Mount Sinai. “PCDC’s leadership and expertise has helped us strengthen our practices, and we are delighted that a Mount Sinai faculty practice is PCDC’s 200th successful NCQA PCMH recognition.”
The Mount Sinai practices demonstrated their PCMH proficiency with initiatives such as notifying primary care providers in real time of unplanned emergency department (ED) visits and hospital admissions, and linking patients to community-based resources/social services. With PCDC’s support, the practices focused on post-discharge monitoring and continued to ensure that frequent visitors to the ED have effective primary care support. With these new systems in place, the practices will be able to help their patients avoid unnecessary ED use and hospital admissions and improve the quality of patient care.
Since 2010, PCDC’s NCQA PCMH-certified content experts have provided strategic leadership, practice coaching and technical assistance that have helped community health centers, hospital outpatient centers, private practices and special needs providers across the country become recognized PCMH primary care practices. (See more on PCDC’s PCMH services here.)
Founded in 1993, the Primary Care Development Corporation (PCDC) is a nationally recognized nonprofit organization dedicated to expanding access to quality primary care, in order to improve the health of families and communities, lessen disparities and reduce health care costs. PCDC offers training and technical assistance on providing health care services that are accessible, high quality, and compassionate; affordable capital to renovate and expand community health centers so that services are offered in settings that promote efficiency, dignity and respect; and advocacy to advance public policies that strengthen and sustain quality primary care. To date, PCDC has helped over 1,000 primary care practices improve delivery of care and leveraged over $670 million on projects that enhance capacity in low-income communities.