Transforming practices for better quality

To encourage and reward practice transformation, Hudson Valley Initiative organization THINC recognized early on the importance of engaging health plans in the process.  In 2009, THINC undertook a pay-for-performance/PCMH project designed to reward physician practices that successfully transformed to the PCMH model.  THINC engaged six health plans that agreed to pay providers based on criteria that lead to better patient outcomes, utilization targets and patient satisfaction.  In its initial year, the PCMH Hudson Valley Initiative required physician practices to achieve National Committee for Quality Assurance (NCQA) Level 2 PCMH recognition status to participate in the pay-for-performance payments. 

The initiative was enormously successful. The participating practices, most from the Taconic IPA network, were given resources and hands-on practice transformation assistance, with 10 months to submit their paperwork for National Committee for Quality Assurance (NCQA) patient centered medical home recognition. As a result of the effort, 11 physician practice groups--including three federally qualified community health centers--operating across 51 practice sites achieved Level 3 NCQA PCP-PCMH recognition within the required timeframe. This accomplishment represents 60 percent of total Level 3 providers in New York, and 11 percent of all recognized providers.  Of note, two more of the original 15 practices selected, representing an additional 16 practice sites, are expected to achieve NCQA recognition before the end of 2010.

To ensure that ideas are effectively achieving goals of better quality outcomes, we advocate research and deployment of resources to enable change. An aggressive research agenda in partnership with Weill Cornell Medical College establishes monitoring and evaluation with studies that include measures of patient satisfaction, physician satisfaction, quality and outcome measures and impact of health IT on quality and performance.  Research like this is invaluable to other initiatives across the country seeking to establish common structures, standards and action steps to enable safer, higher quality health care.

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