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July 6, 2011

NYC Public Hospitals and Health Centers Receive Patient-Centered Medical Home Designation

HHC Primary Care doctor, patient, family

New York, NY - The New York City Health and Hospitals Corporation (HHC) today announced that all of its 11 hospitals and six large community health centers have received medical home designation for delivering accessible, comprehensive and family-centered primary care to New Yorkers that aims to reduce avoidable healthcare costs over time.   The special designation was granted by the National Committee for Quality Assurance (NCQA) to 616 primary care physicians who collectively care for nearly 100 percent of HHC's primary care population of more than 477,000 adult and pediatric patients.  All of the HHC facilities received "Level 3" designation, the highest ranking, which will qualify HHC for more than $15 million in Medicaid reimbursement rate increases every year.

"For years, we have been piecing together the building blocks necessary to provide a true medical home for New Yorkers, which include a tremendous investment in our primary care services, a robust electronic patient medical record system, and an increased focus on real care management – particularly for our patients with chronic disease," said HHC President Alan D. Aviles. "The supplemental payments that will now be directed to support this work are a welcome reward for doing what we know is right for our patients. It is ultimately a front-end investment to help us keep patients healthy and avert future costs to treat illness and long-term complications."

The patient-centered medical home is a model for care that strengthens the physician-patient relationship by replacing episodic care based on illness with a coordinated care management process that promotes long-term health and healing.  The hallmarks of a medical home are an ongoing relationship with a primary care doctor; a physician-led team-based approach with a group of individuals who collectively take care of the patient's ongoing needs across all healthcare settings; a focus on care coordination that is culturally and linguistically appropriate;the use of electronic medical records to ensure that care is delivered safely and prevents redundancy and errors; and the ability to offer access during evenings and weekends.

"A medical home is a place to meet the multiple needs of patients when they need it," said David Stevens, M.D., Director, Department of Medicine, Gouverneur Healthcare Services in Lower Manhattan.  "Patients know they have a team caring for them; it's not just about the doctor.  They can have appointments with a nurse and their Patient Care Associate can help them navigate the system. And when too much time has passed between visits, they will get a call and hear someone say, 'How are you doing? We have not seen you for a while.'"

"A patient-centered medical home model serves as the foundation for ‘accountable care' under national healthcare reform, where hospitals and healthcare systems are going to be held accountable for effectively managing care and promoting the health of their patients and communities," said Ross Wilson, M.D., HHC Chief Medical Officer.   "A primary care medical home is the hub around which payment reform – paying for better healthcare coordination and outcomes – will be built."  

To be recognized as a NCQA patient-centered medical home, healthcare providers must meet a number of safety and quality standards, including giving patients the knowledge and tools they need for self-management of their health, care coordination, evidence-based guidelines for chronic conditions, and performance reporting and improvement. 

"To be truly patient-centered, we have to work more collaboratively and efficiently," said Amanda Ascher, M.D., Medical Director, Segundo Ruiz Belvis Diagnostic and Treatment Center in the Bronx.  "For example, our patients no longer need to wait for a doctor's appointment to get their prescription refills. We created an expedited system that allows nurses to do chart reviews and assessments before the doctor approves a refill.  When you can do this for 30 patients, you save 30 visits, many hours of unnecessary travel and wait time for the patient, and can ensure providers use their time more efficiently and spend it with patients who really need it."

Primary care clinics within the following HHC facilities have been certified as NCQA patient-centered medical homes: Bellevue Hospital Center, Coney Island Hospital, Elmhurst Hospital Center, Harlem Hospital Center, Jacobi Medical Center, Kings County Hospital Center, Lincoln Medical & Mental Health Center, Metropolitan Hospital, North Central Bronx Hospital, Queens Hospital Center, Woodhull Hospital Center, Gouverneur Healthcare Services, Cumberland Diagnostic & Treatment Center, Segundo Ruiz Belvis Diagnostic & Treatment Center, Morrisania Diagnostic & Treatment Center, East New York Diagnostic & Treatment Center, and Renaissance Healthcare Network Diagnostic & Treatment Center (Sydenham site).

These NCQA standards are aligned with the joint principles of the American Academy of Family Physicians (AAFP), the American Academy of Pediatrics (AAP), the American College of Physicians (ACP) and the American Osteopathic Association (AOA), which define the key characteristics of the patient-centered medical home.  To receive the NCQA designation, each physician practice has to submit an extensive application to demonstrate how the standards are being met. Each physician practice is scored on a scale of 100 points and has three possible levels of recognition.  Each level has a corresponding level of supplemental payments attached.  All HHC facilities that have received the NCQA medical home designation achieved the highest ranking at Level 3, which allows for the highest level of reimbursement from New York State.


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