Recently the National Committee for Quality Assurance (NCQA) and the New York State Health Foundation (NYSHealth) jointly sponsored a webinar briefing on the Quality of Health Care in New York State. This represented the first time that NCQA has prepared reports highlighting trends in health care on 122 measures of quality, comparing one state, New York, to its neighbor in the northeast, Massachusetts, as well as against national benchmarks. The data reflects New York’s performance over time, broken out by health plan type. Slides and a video from the event can be accessed here. While the data showed New York ahead of the national results, Massachusetts out performed New York health plans on key quality measures.
New York State has a lot to celebrate. Fifty percent of New York residents are covered by health plans that transparently report standardized measures of quality care known as “Healthcare Effectiveness Data and Information Set” (HEDIS) data to NCQA. This compares favorably to the 40 percent national level and speaks to both regulators’ and insurers’ commitment to improving quality through transparent reporting.
New York has taken yet another leadership position on quality. New York State has the most NCQA recognized patient centered medical homes, more than twice the numbers as the number two state. Many of these practices have been recognized with the support of public and private sector initiatives designed to meet the triple aim of improving patient care, improving the health of the population and reducing costs. With the incentives offered by the NYS Department of Health, almost 40 percent of Medicaid patients receive care through a patient centered medical home. In addition, NCQA recently announced more than 60 specialty care practices who have committed to be early adopters of the patient centered specialty care practice recognition program (PCSP). Fourteen percent of the early adopters were from NYS, the second largest concentration, continuing the state’s practices’ commitment to quality patient centered care.
Furthermore, there are many quality initiatives that are underway or are planned across New York City and the state. Crystal Run Health Care in Middletown, NY, is one of the first NCQA Accredited Accountable Care Organizations (ACOs). This delivery system based on coordinated and collaborative patient centered care can achieve both quality improvements and cost savings because the organization is rewarded for healthcare outcomes, not for the process or volume of the services offered.
New York, as recently as last week, invited insurers to participate in its insurance exchange program and is encouraging insurers to offer “non-standard” value-based insurance options, which will be designed to improve quality of care by reducing cost barriers for high-value services while generating savings through increased consumer cost sharing for services that evidence shows are of uncertain medical value. Lastly, the state continues to focus on improvement in their Medicaid plans and will be offering incentives to healthcare providers for caring for people with both Medicare and Medicaid coverage (“dual-eligibles”).
Following the presentation by Peggy O’Kane, president of NCQA, was a panel discussion with prominent healthcare representatives from both the private and public sector who commented on quality measures, spoke of new state initiatives and recommended other programs toward making New York State the best in the nation. Representatives from the NYS Department of Health (DOH) spoke of the latest five-year plan, which was developed in conjunction with stake holders from all areas of healthcare in a process different from other years, in an effort to promote innovation and transparency. As an example included in this plan is a new office, the Department of Quality and Patient Safety, which will look at ways to achieve improved quality, safety and reduce costs.
The DOH has also participated in the state government initiative to promote transparency in reporting through open.ny.gov, allowing continued user-friendly public access to health data to empower all residents and to inspire creative collaboration of stakeholders to improve the health care delivery system and overall public health for all New Yorkers. The panel agreed that continuing incentives for patient centered medical homes from both the public sector and private sector will be instrumental in improving health outcomes increasing participation in medical home recognition programs while at the same time reducing system costs. In addition, promotion of the benefits of medical homes to patients, as the end-user will also be critical to success.
RMS Healthcare has been witness to many of the healthcare advances first-hand. We have worked with primary care practices as they have pursued the journey to become a patient centered medical home and have extended our healthcare consulting services to specialty care practices. We understand the importance and value in achieving and maintaining quality benchmarks. Having assisted practices with both private pay patients and Medicaid/Medicare patients, we understand the challenges in achieving these benchmarks.
Whether you are a primary care or specialty care practice seeking further information about improving patient care, RMS Healthcare can meet your specific needs with a full complement of healthcare consulting and management services. For more information, contact Susan Maxsween, Director of Healthcare and Practice Transformation (315) 635-9802 or by emailing her at SusanM@RMSresults.com. For other RMS Healthcare blog posts, click here.
