Hudson Valley Comprehensive Primary Care Initiative

Capital District - Hudson Valley

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Program Location: 
Albany, NY
Number of Practices: 
74
Payer Type: 
Multi-Payer
Partner Organizations: 
Taconic Health Information Network and Community (THINC)
Parent Program: 
CMS Comprehensive Primary Care Initiative
Payers: 
Medicare
Aetna
Capital District Physicians' Health Plan (CDPHP)
Empire Blue Cross
Hudson Health Plan
MVP Health Care
Teamsters Multi-Employer Taft Hartley Funds
Medicaid

Reported Outcomes

Description: 

The multi-county New York Capital District-Hudson Valley region is one of only seven markets selected to be part of the multi-payer effort to foster collaboration among public and private health plans.  In addition to Medicare, the six health plans that are participating are Aetna, Capital District Physicians' Health Plan (CDPHP), Empire Blue Cross, Hudson Health Plan, MVP Health Care, and the Teamsters Multi-Employer Taft Hartley Funds. The Capital-Hudson Valley CPC region includes Albany, Columbia, Dutchess, Greene, Orange, Putnam, Rensselaer, Rockland, Schenectady, Sullivan, Ulster, and Westchester counties;  75 primary care practices were selected to participate through a competitive application process, which includes 286 providers and approximately 40,500 beneficiaries. 

Program Website

Related News & Resources

CPC 2015 mid-year snapshot
December 2015 - Resource
Patient Experience Over Time in Patient-Centered Medical Homes
May 2013 - Resource
Payment Model: 

Under the Comprehensive Primary Care Initiative, CMS will pay primary care providers for improved and comprehensive care management, and after two years offer them the chance to share in any savings they generate. CMS will look to collaborate with other payers in local markets who will commit to similar changes to how they engage primary care practices.

  • Monthly Care Management Fees for Medicare Fee-for-Service Beneficiaries: CMS will pay participating practices a risk adjusted, monthly care management fee for their Medicare Fee-for-Service beneficiaries. For the first two years of the initiative, the per-beneficiary, per-month (PBPM) amount will average out to $20; for years 3 and 4, the PBPM will be reduced to an average of $15.
  • Shared Savings in Medicare Fee-for-Service: After two years, all practices participating in this initiative will have the opportunity to share in a portion of the total Medicare savings in their market.
Fewer ED / Hospital Visits: 

Mathematica Evaluation (January 2015) Independent evaluation of first program year prepared for CMS

Among all patients in New York, there were two statistically significant impacts for the CPC group relative to the comparison group:

  • A decline in annual hospitalizations of 19 per 1,000 patients (6 percent), beginning in Quarters 1 and 2  
  • An increase in annual specialist visits in all settings of 455 per 1,000 patients (3 percent), with quarterly impacts indicating effects occurring in Quarters 1 and 3

Among high-risk patients in New York, there were two statistically significant findings for the CPC group relative to the comparison group during Year 1:

  • A decline in annual hospitalizations of 59 per 1,000 patients (9 percent).
  • An increase in annual observation stays of 13 per 1,000 patients (21 percent). 
Improved Health: 

Mathematica Evaluation (January 2015) Independent evaluation of first program year prepared for CMS

Among all patients in New York, there were several statistically significant improvements for the CPC group relative to the comparison group in the quality-of-care measures during the first year of CPC:

  • HbA1c testing for patients with diabetes increased by 4 percentage points (5 percent).
  • Lipid testing for patients with diabetes increased by 2 percentage points (3 percent). 
  • The likelihood of not complying with all four diabetes tests/exams declined by 1 percentage point (29 percent).
  • Lipid testing among patients with IVD increased by 3 percentage points (4 percent).
  • 14-day follow-up visits after a hospital discharge rose by 3 percentage points (4 percent).

Similarly, among high-risk patients in New York, there were also many statistically significant improvements in quality-of-care measures for the CPC group relative to the comparison group, including: 

  • HbA1c testing among patients with diabetes increased by 7 percentage points (9 percent).
  • Lipid testing among patients with diabetes increased by 5 percentage points (6 percent).
  • Urine protein testing among patients with diabetes increased by 8 percentage points (14 percent).
  • All four tests for patients for diabetes increased by 7 percentage points (22 percent).  
  • Lipid testing among patients with IVD increased by 4 percentage points (5 percent).
  • 14-day follow-up visits after a hospital discharge increased by 4 percentage points (6 percent)
Other Outcomes: 

Mathematica Evaluation (January 2015) Independent evaluation of first program year prepared for CMS

During the first year, there were no statistically significant effects on annual Medicare expenditures, either with or without care management fees, among all attributed patients or highrisk patients in New York

Data Source(s): 
Mathematica Policy Research (January 2015)
Last updated May 2018
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