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New program rewards top care from NYC docs

October 13, 2010 | Mike Miliard, Managing Editor

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NEW YORK – The Health Care Incentives Improvement Institute (HCI3) and the New York City Health Department's Primary Care Information Project have partnered to develop a program to recognize physicians who deliver high-value primary care to adult patients in New York City.

The Adult Primary Care Recognition Program will help clinicians identify patients who need chronic care management and preventive services such as cholesterol management and blood pressure control – and encourage the doctors to take an active approach to treatment.

Officials say the impact could be substantial, given the estimated 25 percent of New York City residents who suffer from hypertension, with less than half having their blood pressure under adequate control. By keeping people well, a key goal of this new program is to cut preventable hospitalization by 17 percent, reducing overall medical expenses in New York City significantly.

"There are substantial avoidable costs associated with the management of chronic conditions," said Laurel Pickering, executive director of the New York Business Group on Health, a coalition of employer purchasers. "By reducing preventable complications incurred by most patients, we could considerably improve the health of employees and at the same time save employers billions of dollars."

The aim of the Adult Primary Care Recognition Program is to recognize and reward clinicians who are delivering high-value primary care and reduce gaps and disparities in care while reducing complications that may lead to premature death.

All physicians in New York City have an opportunity to participate in the effort electronically through the NYC Health Department's Take Care New York measures database. Doctors and clinicians who demonstrate high performance can earn recognition and may also qualify for incentives from participating employers and health plans. Twenty-seven physicians have currently earned the distinction.

Several national and regional plans use or plan to use HCI3's Bridges to Excellence (BTE) programs as part of their pay-for-performance initiatives, including Empire BlueCross BlueShield.

"By reducing the reporting burden and focusing on appropriate measures, physicians can focus on providing high quality patient care," said Mary Donnelly, RN, quality manager, New York Chapter, American College of Physicians.

The BTE Adult Primary Care Recognition Program leveraged the efforts of the NYC Health Department's Primary Care Information Project (PCIP) and their work with eClinicalWorks, an ambulatory clinical systems firm, to significantly reduce the reporting burden on practices.

More than 2,600 physicians participate in PCIP. This work will expand to include more EHR systems now that PCIP has been designated a Regional Extension Center for Health IT, with a goal to assist local physicians at every stage of EHR adoption and use.

"Incentive programs are beneficial in helping practitioners to increase clinical quality performance," said Noam Meyerovich, MD, an internist who is a program participant and a BTE Recognized physician. "An incentive program also helps doctors to organize office workflow and reminds and helps doctors to focus more on preventive medicine, which really improves patients care."

Mike Miliard
Managing Editor of Healthcare IT News
Follow Mike on Twitter @MikeMiliardHITN
Related Topics:
  • Mike Miliard
  • New York
  • New York
  • New York Chapter
  • New York City
  • The Health Care Incentives Improvement Institute
  • Quality and Safety

Reader Comments (3)Login to Post a Comment

AParsons says: Reducing burden of quality reporting
October 14, 2010 | 8:14AM GMT

For this program, physicians who belong to NYC's Primary Care Information Program (www.nyc.gov/pcip) and have adopted an EMR can elect to have their quality data shared for the BTE data. The data warehouse described in the article receives monthly aggregate (no patient level data) quality measure scores that are derived from the EMR and transmitted monthly. Providers don't have to do anything to transmit the data. This significantly reduces the burden of reporting for them. The data is then used by the team at PCIP for several things 1) to assess the effectiveness of EMRs as a "quality intervention" 2) to provide physicians with comprehensive assessments of the care they provide across all their patients 3) to give providers an opportunity, if they wish to participate, to be a part of pay-for-performance programs that they qualify for based on their quality measure scores.
Providers are uniformly disatisfied with chart reviews, billing codes or claims being the basis for assessing quality of care derived. This novel program explores the possibility of using EMR derived data, entered by the physician and the care team, to identify and reward quality care.

Tom Sowa says: New program to reward NYC docs .... i'm confused
October 13, 2010 | 5:26PM GMT

What I can't tell from this story is the requirements this program would impose in terms of compliance and participation. Further clouding things the story suggests one can soften the reporting burden through a related partnership. But I'm totally lost now, since the story suggests (to me) participation involves adding data to the NYC Health Department's Take Care New York measures database. So, does it require docs to add more data to the database? And how then is the reporting burden softened?

pinky says: Chronic disease management
October 13, 2010 | 1:16PM GMT

Chronic disease management should be the emphasis of many programs now . Preventative care is more cost effective and its long overdue that it be noted and implemented.

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