New York

Aetna launched its patient-Centered Medical Home (PCMH) program in New York in May of 2013. The program recognizes primary care physicians (PCPs) who more actively coordinate and manage their patients’ care across the health care system. By strengthening the role of PCPs, the PCMH program aims to improve patient health outcomes.

Under this demonstration, CMS will participate in multi-payer reform initiatives that are currently being conducted by states to make advanced primary care practices more broadly available. Advanced primary care (APC) practices, or “medical homes,” utilize a team approach to care, with the patient at the center. APC practices emphasize prevention, health information technology, care coordination and shared decision making among patients and their providers. The goal is to improve the quality and coordination of health care services.

New York implemented its 2703 Health Home initative in 3 phases, through 3 State Plan Amendments.

The P2 Collaborative is integrating the medical home model into a new regional planning initiative for Western New York. It is one of 16 communities in the country selected by the Robert Wood Johnson Foundation to be an Aligning Forces for Quality (AF4Q) community. P2 Collaborative has been working to establish a community based approach to providing quality improvement, change management and technical assistance resources to assist health care practices in achieving Patient-Centered Medical Home.  The P2 Collaborative uses a Community Extender Model to serve the practices in the region.

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 Primary Care Information Project (PCIP) is a bureau of the New York City Department of Health and Mental Hygiene (NYCDOHMH) whose main mission is to improve population health through health information technology and data exchange. PCIP can be categorized as a technical assistance provider and subjectmatter expert, helping large and small primary care practices implement prevention-oriented EHR with built-in core functionality (like quality measure calculations, registry functions, and chronic-disease focused clinical decision support).

The state of New York receivied a Pre-Testing Award from the Centers for Medicare & Medicaid Services to further develop and refine its comprehensive State Health Care Innovation Plan. New York’s State Health Innovation Plan serves as a roadmap to achieve the “Triple Aim” for all New Yorkers: improved health, better health care quality and consumer experience, and lower costs.

The Adirondack Region Medical Home Demonstration Pilot is a joint initiative of medical providers and public and private insurers to transform health care delivery in this rural, upstate New York Region. Its goals are to improve care, expand access and contain costs. It accomplishes these goals by emphasizing preventive care, enhanced management of chronic conditions, and by assuring a close relationship between patients and their primary care providers.The Commissioner of Health has the authority to continue the Adirondack program until March 31, 2014.

Finger Lakes Health System Agency is receiving a CMS Health Care Innovation Award for a community-wide outcomes-based payment model for primary care that will serve Medicare and Medicaid beneficiaries in six counties in the Rochester, New York area. The project creates a collaborative of providers, payers, employers, government, patients, social coalitions, and community service organizations to integrate community services with primary care and leverage social and health care resources.

The Fund for Public Health in New York, Inc., in partnership with the New York City Department of Health and Mental Hygiene’s Division of Mental Hygiene, is receiving a CMS Health Care Innovation Award to implement Parachute NYC, providing need-adapted treatment model (NATM) interventions for Medicaid beneficiaries and other people with serious mental illness who have a diagnosis of psychosis. Persons with psychosis are likely to rely on crisis-based care and generally lack adequate preventive care.