Announcing New York State PCMH Program

June 8, 2018 · NCQA Communications

New York State PCMH Program

There is a trend afoot that we are happy to see…health care that’s moving toward a value-based delivery system – that is paying doctors for the quality of care and keeping patients healthy.  At the same time, we are also seeing more primary care practices turning to the patient-centered medical home (PCMH) model.

PCMH is care where the primary care team is responsible for managing the full spectrum of health care needs and coordinating care with specialty clinicians. It’s whole person, patient-centered care. We think its a good model of primary health care and now states around the country are seeing that too.

Some states are encouraging practices to earn their NCQA PCMH recognition.  Case in point is the New York State Department of Health, which worked with NCQA to develop an exclusive transformation program for New York state practices.

The new NYS Patient-Centered Medical Home (NYS PCMH) program supports the state’s initiative to advance primary care and promote the Triple Aim: better health, lower costs and better patient experience.

New York State PCMH Program

The NYS PCMH program coordinates programs in the state by moving primary care practices toward an exclusive model to improve care, reduce health care costs and strengthen value-based contracting.

“Under Governor Cuomo’s leadership, New York state continues to make game-changing healthcare reforms that improve care and reduce costs through a value-based payment model,” said New York State Department of Health Commissioner Howard A. Zucker, MD, JD. “The New York State Patient-Centered Medial Home will improve consistency in certification over multiple transformation programs currently being phased in across the state for primary care providers.”

“This paves the way for states to build upon the NCQA PCMH Recognition Program to align with the unique health goals in their state. New York identified specific criteria relevant to their goals–behavioral health integration, more rigorous care coordination and value-based payment arrangements–and worked with us to include them in the program,” said Frank Micciche, Vice President of Public Policy at NCQA. “This shows how states can leverage existing strong, evidence-based programs to meet state needs for better care and stronger patient engagement.”

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.

Additional Benefits 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.
• Transformation assistance.
• Enhanced reimbursement opportunities.

This program is offered to eligible primary care practices in New York state.  In addition, one-on-one technical support through contracted transformation assistance vendors is available at no cost to participating practices (for a limited time based on the availability of funding). Click here for more information.