NCQA recognizes 51 primary care practice sites as Level 3 patient-centered medical homes

Taconic IPA helps to aid 51 sites to transform to new model of care

An innovative quality initiative in the Hudson Valley has resulted in National Committee for Quality Assurance (NCQA) Recognition of 51 primary care practice sites as Level 3 patient-centered medical homes, the highest level achievable. This groundbreaking accomplishment was achieved by 236 physicians within 11 primary care practice groups (7 medical groups with multiple practice locations and 4 single site practices) and represents 44 percent of total Level 3 clinicians in New York, and nearly 10 percent of all practices at this level across the country.

The practices were supported in their transformation by the Taconic Independent Practice Association (TIPA), the nearly 4,000-member strong physician leadership organization focused on innovative initiatives to transform medical practices and improve health care quality in the Hudson Valley. Physician practices were selected for the project based on their known commitment to quality improvement efforts in the past and their advanced, robust use of health information technology. Although NCQA Level 2 Recognition was the initial project goal, all 11 practices exceeded the goal to reach NCQA Level 3 status.

Three federally funded community health centers were among the Hudson Valley practices to achieve this recognition. Importantly, the project included two solo practitioners and several small practices, demonstrating that physician practices of all sizes and types can become patient-centered medical homes.

"The Hudson Valley Initiative has really set the bar on a very strategic process to bring a large number of practices up to the state of the art of the medical home. We applaud their success and urge other communities just beginning the journey to look at this demonstrated success and learn from it," said NCQA President Margaret E. O'Kane.

The patient-centered medical home (PCMH) is an emerging model of care in which patients select a primary care practice to be their "medical home." Work flow at practices is redesigned to emphasize a team-based approach to care. New processes within the practice focus on coordination of care, quality, safety and preventive care, and are supported by the use of health information technology tools such as electronic health records, electronic prescribing, an electronic patient registry and clinical decision support.

NCQA recognizes practices that have achieved medical home status through its Physician Practice Connections® - Patient-Centered Medical Home™ program. NCQA offers three levels of recognition based on the program standards.

Over the course of the one-year project, the leadership of the selected practices met monthly as the Taconic IPA Medical Council to collaborate, share best practices and facilitate solutions. The medical home transformation project was managed by the Taconic Health Information Network and Community (THINC), the not-for-profit organization that convenes providers, payers, employers, public health agencies, quality organizations, consumers and local leaders to improve the quality, safety and efficiency of health care for the community. Taconic IPA funded consulting services from TransforMED and Masspro to assist the practices as they worked to adopt more efficient, effective care delivery practices.

"This was a collaborative process, with Taconic IPA funding consulting and practice support resources, the THINC community managing the overall project and the practices themselves providing staff and resources to make the transformation," said A. John Blair III, MD, president of Taconic IPA. "Six health plans and IBM also promised incentive payments to the practices for meeting the project goals."

The Hudson Valley practices that earned NCQA PPC-PCMH Level 3 Recognition are:

• Bridge Street Family Medicine in Saugerties, NY, six physicians;
• Clarkstown Pediatric Associates, headquartered in New City, NY, nine physicians at three sites;
• Community Primary Care in Hopewell Junction, NY, solo physician;
• Crystal Run, headquartered in Middletown, NY, 42 physicians at six sites;
• Hudson River HealthCare, headquartered in Peekskill, NY, 28 physicians at 11 sites;
• Hudson Valley Primary Care in Wappingers Falls, NY, two physicians;
• Imtiaz A. Mallick, MD, FACP in Fishkill, NY, solo physician;
• Institute for Family Health, headquartered in New Paltz, NY, 27 physicians at five sites;
• Mount Kisco Medical Group, headquartered in Mount Kisco, NY, 59 physicians at 11 sites;
• Open Door Family Medical Group, headquartered in Ossining, NY, 16 physicians at four sites; and
• WestMed Medical Group, headquartered in Purchase, NY, 45 physicians at seven sites.

The PCMH project includes a quality improvement element to evaluate patient and provider satisfaction and quality outcomes. Data is being collected and evaluated by researchers at Weill Cornell Medical College to determine whether the new model of care meets its promise of improving care while controlling costs.

The 11 practices are extending the scope of the project over the course of 2010 with a new initiative to improve care coordination. As part of this initiative, the practices will train staff and become certified in the Johns Hopkins University Guided Care program, conduct most of the elements of the Consumer Assessment of Healthcare Providers and Systems survey, and participate in expanded quality monitoring.