GHI AND HIP LAUNCH PILOT MEDICAL HOME NETWORK PROJECT WITH SUPPORT FROM COMMONWEALTH FUND
Program is first of its kind in New York. Expected results include higher quality care, increased efficiency, and better patient outcomes.
January 8, 2008, New York, NY -- Group Health Incorporated (GHI) and HIP Health Plan of New York (HIP) will launch a Medical Home High Value Network project, the first of its kind in New York, that will provide adult primary care physician practices in New York with the opportunity to become medical home practices. GHI and HIP see this as a critical element in the future to providing health care services to people in New York. The program evaluation is supported by a grant from The Commonwealth Fund to the Ethel Donaghue Center for Translating Research into Practice and Policy at the University of CT Health Center.
The American College of Physicians and the American Academy of Family Physicians have proposed that all primary care physician practices transform themselves into medical homes. The medical home concept employs a team approach to patient care led by a personal, primary care physician, offering much higher levels of performance in terms of patient experience, quality of care, and efficiency of resources when compared to traditional practices.
The Medical Home healthcare team provides direct services and coordinates services among other physicians and licensed health care providers for each patient. Patients have access to enhanced appointment systems, telephone and email communication, clinical decision support tools that guide evidence-based practice, the use of health information technology, and support for patient involvement in informed decision making and self-care.
To assess the effectiveness of the program, participants will be randomly assigned into a supported group and a comparison group, each comprised of 25 adult primary care physician practices. The total number of participants in the supported group is expected to include approximately 100 physicians and 20,000 patients.
The supported group will be paid using revised payment methodology and will receive technical support for office redesign and care management. Data on the success of the project will be derived from submissions of claims and performance measures of quality for procedures such as mammograms, diabetes testing, and cervical cancer screenings; outcomes for diabetes and hypertension; efficiency measures; and patient experience measures such as overall satisfaction, access, self-care support, and physician communication.
The Ethel Donaghue Center for Translating Research Into Practice and Policy (TRIPP) will track and assess the experiences and challenges faced by the medical practices, as well as the resulting impact on quality, as these practices transform into patient-centered medical homes. TRIPP will use the Physician Practice Connections-Patient-Centered Medical Home, a tool developed by the National Committee for Quality Assurance (NCQA), an independent, not-for-profit organization dedicated to measuring the quality of America's health care, to assess the extent to which medical practices adopt the principles of medical home. At the end of the two-year study period, the TRIPP Center will independently compile, analyze, and publish project results.
"Physicians in our networks are important partners in the care that is provided to our members," said Dr. Aran Ron, GHI President. "In this project we are committing to helping groups of physicians transform their practices according to the patient-centered medical home concept that has been developed and endorsed by the primary care specialty societies."
"The patient-centered medical home model holds great promise for extending the physician-patient relationship beyond the confines of the doctor's office," said Margaret E. O'Kane, President of NCQA. "Well-considered efforts such as this one will use standardized tools to assess patient-centered medical homes. It's important to be able to compare the results of this project with that of others to advance our understanding of the value of medical homes."
"The combined approach of support for primary care practices to transform into patient-centered medical homes, in addition to enhanced payment for costs associated with coordination of care, will test promising models of high performance for physician practices and health plans across the country," said Commonwealth Fund President Karen Davis.
Interested HIP and GHI physicians who would like to learn more this program may contact Barbara Kupferman, RN at 1-646-447-7276 or bkupferman@hipusa.com.
About GHI
Group Health Incorporated (GHI) is a statewide health insurer serving New Yorkers since 1937. GHI and its wholly owned subsidiary, GHI HMO, provide health care coverage and administrative services to more than 2.6 million people. GHI offers customers a variety of PPO, EPO, and HMO programs, as well as prescription drug, dental, and vision plans. Throughout its history GHI has pioneered many of the programs that are now standard in the health insurance field. In 2006, GHI affiliated with HIP Health Plan of New York under a common parent, EmblemHealth, Inc. HIP and GHI serve more than four million members and provide access to nearly 92,000 physicians and other providers in 142,000 locations. For additional information about GHI, please visit www.ghi.com.
About HIP
HIP Health Plan of New York is the largest HMO in New York City based on commercial membership. HIP provides access to physician services and hospital care in a variety of ways. HIP contracts with more than 160 hospitals, including major acute care institutions, in New York, Connecticut, and Massachusetts to provide services to members. HIP's combined membership is approximately 1.3 million. For additional information about HIP, please visit www.hipusa.com. It is available in English, Spanish, Chinese and Korean.
