New York State PCMH: Continuing to Gain Steam

March 29, 2019 · Karen Proffitt

Last spring, the New York State Department of Health (NYSDOH), in collaboration with NCQA, launched the New York State Patient-Centered Medical Home (NYS PCMH) Recognition Program.

To date, 292 practices, representing more than 1,500 clinicians, have earned NYS PCMH Recognition and more than 1,000 more practice sites are currently seeking recognition. Over 2,100 practices in New York have already earned NCQA Recognition and will transition to the NYS PCMH Recognition with their current recognitions are up for renewal.

The NYS PCMH Recognition Program focuses on care coordination, population health, evidence-based guidelines and effective use of HIT to meet patients’ needs. NYS PCMH Recognition helps practices put the structure, systems and processes in place to be effective medical homes and achieve the Triple Aim: better health, lower costs and better patient experience.

What are the Benefits?

The NYS PCMH model helps practices:

• Improve patient-centered access and patient experience.
• Perform comprehensive health assessments to identify patient needs.
• Deliver better preventive care such as immunizations and cancer screenings.
• Prioritize comprehensive care management to keep chronic conditions under control.
• Coordinate with other clinicians involved in patient care and close referral loops to improve continuity and avoid gaps.
• Identify patients who require recommended interventions and patients who need medication monitoring.

What Resources Are Available for Practices?

To support the efforts required in transforming New York practices to this new, exclusive model of patient care, NYSDOH provides the following resources:

• Recognition at no cost to practices. NYSDOH covers the first year NYS PCMH Recognition fee or the first NYS PCMH Annual Reporting fee. The practice is responsible for their Annual Reporting fee each year after earning NYS PCMH Recognition.
• Free transformation assistance. New York State contracted with 15 organizations that specialize in NYS PCMH transformation and are available at no cost to participating practices. These entities provide step-by-step assistance in managing the transformation process and support the efforts of improving the patient experience.
• Enhanced reimbursement opportunities. Practices that participate in NYS PCMH transformation may be eligible to receive supplemental payments through State programs such as the Medicaid PCMH Incentive Program. In addition, NYSDOH is engaged regionally with commercial payers to implement voluntary, multi-payer value-based payment (VBP) arrangements. This supports practices that have not had these opportunities through previous transformation efforts. Many of these models and eligibility to participate will depend on practices achieving NYS PCMH recognition.

How to Get Started

To begin applying the standards to the practice, download the NYS PCMH Standards and Guidelines. This contains the requirements for the program, and works with a Transformation Assistance Contractor . To learn more about this program you can also speak to an NCQA representative by filling out this form