HHC Will Award Up to $59 Million in Bonus Payments to Physicians for Achieving Quality, Efficiency Targets and Improving Patient Health

News

FOR IMMEDIATE RELEASE
January 12, 2013

More than 3,300 Public Hospital Doctors Employed Through Contracts With the NYU School of Medicine, Mt. Sinai School of Medicine and the Physician Affiliation Group of NY Will Qualify To Receive Pay for Performance Incentives

New York, NY ― The New York City Health and Hospitals Corporation (HHC) today announced a new pay-for-performance agreement that will reward doctors with up to $59 million in incentive payments over the next three years for meeting the public hospitals system's goals to improve patient care, efficiency, patient satisfaction and align with the new demands of healthcare reform. Under renewed contracts with two major medical schools and one private physician organization that provide the majority of doctors for the public hospitals, physicians will receive bonuses if they lower readmission rates, deliver more coordinated primary and preventive health services, improve communication with patients, decrease emergency room wait times, and run more efficient operating rooms. The performance incentive payments also are tied to benchmarks that, if achieve, would help maintain or secure future reimbursement income to HHC and represent a policy shift away from the cost of living or other wage increases that have traditionally been part of the public hospitals' physician contract agreements.

"We have successfully negotiated a new pay for performance program with our physician affiliate groups to provide additional payments to doctors based on measurable goals to help improve the health of our patients and the efficiency of our care delivery system," said HHC President Alan D. Aviles. "The new bonus payments are directly linked to clinical and leadership activities where physicians can have the most impact. By setting these improvement targets and awards we more actively focus and facilitate the collaborative work necessary to render better care while also shoring up the financial viability of our system going forward. This fundamental shift in the compensation approach for our physician workforce is the latest building block toward readying our system to meet the demands of fast evolving healthcare reform."

The performance improvement targets included in the HHC physician affiliation contracts with the New York University School of Medicine, the Mount Sinai School of Medicine and the Physician Affiliate Group of New York, are based on meeting or exceeding benchmarks set by national healthcare and quality improvement agencies including the Centers for Medicare and Medicaid Services (CMS), the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), and the National Committee for Quality Assurance (NCQA).

Under the new pay-for-performance program, HHC will reward physicians if they meet the following standards:

improve care coordination in primary care centers and maintain HHC's NCQA certification as a level 3 Patient-Center Medical Home under the stricter criteria that is now in effect for 2013;
improve patient satisfaction survey scores and specifically exceed the national average on two of the ten main measurements: the doctor-patient communication and communication about new medications;
reduce 30-day readmission rates from congestive heart failure and pneumonia;
maintain on-time start times for surgery to improve efficiency;
reduce the amount of time from triage to exit from the emergency room for patients who are admitted to the hospital;
reduce average length of stay in the hospital.

In addition to the patient care goals, the pay-for-performance incentives are also tied to standards that have direct financial implications for HHC:

As of October 1, CMS is decreasing hospital payments by up to 1 percent of their base Medicare reimbursement for patients who are excessively readmitted to the hospital within 30 days of their last admission and the potential penalty will increase to 2% at the end of next year and to 3% by the end of 2015.
As of October 1, CMS is also applying value-based purchasing criteria, including patient satisfaction scores and adherence to certain evidence-based best clinical practices that can decrease or increase Medicare rates by 1% this coming year and by 2% in 2017.
The NCQA Patient-Center Medical Home level 3 designation that HHC has achieved must be maintained under stricter criteria in effect for 2013 in order to secure increased Medicaid reimbursements of more than $20 million annually.

The bonus payments will be divided as follows: an additional $13.75 million in incentive pay to the Mt. Sinai physician group, $14 million to the NYU physician group, and $31.3 million to the PAGNY group over the next three years.

The Mt. Sinai School of Medicine provides general medical care and behavioral health services to patients at Elmhurst Hospital Center and Queens Hospital Center. Their contract with HHC is valued at $618 million. The NYU School of Medicine provides the physician workforce at Bellevue and Woodhull Hospitals, two large diagnostic and treatment centers: Gouverneur Health and Cumberland, and Coler-Goldwater Specialty Hospital and Nursing Facility. That combined contact is valued at $722 million. The PAGNY contract has a combined value of $1.275 billion to provide the physician workforce at Coney Island, Harlem, Lincoln, Metropolitan, Jacobi, North Central Bronx Hospitals, and at three large diagnostic and treatment centers: Renaissance, Belvis and Morrisania. All three contracts are for three years and were effective July 1, 2012.

Contact: Ian Michaels (HHC) (212) 788-3339

About HHC

The New York City Health and Hospitals Corporation (HHC) is a $6.7 billion integrated healthcare delivery system with its own 420,000 member health plan, MetroPlus, and is the largest municipal healthcare organization in the country. HHC serves 1.4 million New Yorkers every year and more than 475,000 are uninsured. HHC provides medical, mental health and substance abuse services through its 11 acute care hospitals, four skilled nursing facilities, six large diagnostic and treatment centers and more than 70 community based clinics. HHC Health and Home Care also provides in-home services for New Yorkers. HHC was the 2008 recipient of the National Quality Forum and The Joint Commission's John M. Eisenberg Award for Innovation in Patient Safety and Quality. For more information, visit www.nyc.gov/hhc or find us on facebook.com/nycHHC or twitter.com/HHCnyc.