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National Leadership: The Adirondack Medical Home Pilot Hudson Headwaters has been one of the leaders in developing the Adirondack Medical Home Pilot, a joint effort by medical providers and public and private insurers to transform health care delivery. The Pilot’s goals are to improve care, expand access and contain costs. The Pilot includes more than 30 primary care practices (representing some 100 physicians and a like number of physician assistants and nurse practitioners), five hospitals, seven commercial health plans, Medicare and Medicaid, the New York State Department of Health, the Medical Society of the State of New York, and the New York State Association of Counties. It covers a large, rural area in upstate New York, the size of Connecticut, with about 200,000 people.
The Pilot is among the largest multi-payer patient-centered medical home programs in the nation, and one of only eight to receive funding for Medicare patients from the Centers for Medicaid and Medicare Services. For Hudson Headwaters, becoming a nationally recognized patient-centered medical home has meant changed and improved clinical practices at its 13 health centers.
Meeting Higher Standards, Employing Electronic Medical Records
All health care providers participating in the Adirondack Medical Home Pilot are required to meet standards for care set forth by the National Committee on Quality Assurance. These include the use of the use of e-prescribing and electronic medical records. Both are now standard practice at Hudson Headwaters. In addition, our patients have access to their medical information on their own computers. (See Patient Portal link on the homepage of this website.)
Hudson Headwaters has achieved Level 3 recognition from the National Committee for Quality Assurance (NCQA) – its highest rating -- for meeting evidence-based standards for improving quality and reducing costs. NCQA’s Medical Home Recognition Program defines a patient-centered medical home as a model of care that strengthens the relationship between the patient and their primary care physician, while reflecting a commitment to access, affordability and accountability. The standards emphasize dedication to continuous quality improvement.
Hudson Headwaters’ application to the NCQA was sponsored by the Health Resources Services Administration (HRSA), the agency that provides oversight to Federally Qualified Health Centers (FQHCs) like Hudson Headwaters.
Increased Responsibility/Better Cost Control
Under the terms of the Adirondack Medical Home Pilot, primary care providers receive increased payment for services in exchange for expanded responsibility for coordinating care, providing preventive services and managing chronic disease. The increased reimbursement is expected to be offset by decreased costs from fewer emergency room visits, fewer hospital admissions, lower prescription costs, and overall better health.
The Pilot’s disease management focuses on chronic illnesses that account for nearly 80% of health care spending, including diabetes, hypertension, coronary artery disease and asthma.
The Pilot has a five-year time frame to demonstrate that its changes in the delivery of care have improved patient health and contained costs. It began in January 2010.
A Proven Approach
The patient-centered medical home model has been shown to deliver impressive health care value. The Geisinger Health Care System, a large rural health care organization in Pennsylvania, has reported that its medical home program reduced hospital admissions by 20%, saving 7% of total medical costs. Moreover, the program eliminated common health care delivery problems including unjustified variation (different approaches to care in different locations), perverse payment incentives (more money for more work with irrelevant outcomes), and lack of coordination among caregivers.
While Geisinger has shown that this model for care works in integrated health systems, where one organization controls all aspects of care, the Adirondack version unites independent health care players -- hospitals, public and private insurers, primary care providers and specialists -- in a voluntary collaboration.
For more information on the Adirondack Medical Home Pilot, click here.
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