The following blog post was written by Karen Joncas, a Healthcare Transformation Coordinator at RMS.
RMS Healthcare is a leader in healthcare transformation services, and has assisted over 200 practices in their journey to Patient-Centered Medical Home (PCMH) recognition. Primary care practices that have patients enrolled in a Medicaid or Managed Medicaid insurance program will benefit from the recent New York State implementation delay for the revised incentive plans for NCQA recognized primary care practices. Effective January 1, 2016, the New York State Medicaid Program is changing the Patient-Centered Medical Home Statewide Program Incentive payments for providers recognized by the National Committee for Quality Assurance (NCQA) under the PCMH 2011 recognition standards. The new policy applies to both Medicaid Managed Care and Fee-for-Service (FFS). Payments will be reduced for those practices with level 2 or 3 recognition under the 2011 standards, and will be significantly increased for those practices recognized under PCMH 2014. The revised policy and delayed implementation date is designed to incentivize New York State healthcare providers to seek recognition under the more robust standards of the PCMH 2014 program. Ultimately, the Medicaid Redesign Team and State Health Innovation Plan hope to improve care, reduce per capita cost, and improve population health. As a result, all incentive payments for providers recognized through PPC-PCMH program (2008 standards) will be eliminated effective April 1, 2015. Physician practices from other states should check with their state Medicaid departments for rules applying to local incentive payments.
To review the schedule and details of the Patient-Centered Medical Home Statewide Program Incentive Payment contained within the March 2015 New York State Department of Health Medicaid Update, click here.
RMS Healthcare can help your practice attain a higher level of recognition or recognition under the PCMH 2014 program in order to maximize your state incentive payments. For more information, please contact Susan Maxsween, Director of Healthcare and Practice Transformation at 1-866-567-5422 or e-mail her at SusanM@rmsresults.com.