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February 20, 2014 

Primary Care Practice at Three Brooklyn HHC Facilities Recertified as Highest Level Patient-Centered Medical Homes

New York, NY ― Continuing the New York City Health and Hospitals Corporation’s (HHC) commitment to provide the highest level of primary care at all its locations, HHC President Alan D. Aviles announced today that the primary care practices at three HHC facilities in Brooklyn have achieved recertification as “Level 3” Patient-Centered Medical Homes, the highest accreditation level possible, from the National Committee for Quality Assurance (NCQA). The NCQA is a private non-profit organization that accredits and certifies a wide range of healthcare organizations in their effort to become a certified Patient-Centered Medical Home (PCMH).

The three Brooklyn HHC facilities are: Coney Island Hospital, Woodhull Medical Center, and the Cumberland Diagnostic & Treatment Center.

Patient-Centered Medical Homes promote a partnership that allows the patient and his or her care team to get to know each other and work together to improve the patient’s health. A personalized care plan is developed for patients that need them, and the patient’s care team will review the plan regularly to ensure that it is working to keep the patient healthy. The team keeps up with the patient’s health progress, tracks test results and health screenings, and makes sure the patient receives the right care at the right time.

PCMHs are particularly effective at promoting routine and preventive primary care, and have been found to reduce emergency room visits among their patients. Primary care practices at all of HHC’s 11 hospitals plus its six large community health centers have qualified as PCMHs at Level 3, making them eligible for the highest level of Medicaid reimbursement.

Read more about Patient-Centered Medical Homes on the website of the New York City Health and Hospitals Corporation here.

“The NCQA Patient-Centered Medical Home is a model of 21st century primary care that combines access, teamwork and technology to deliver quality care and improve health,” said Arthur Wagner, Executive Director of Coney Island Hospital.

Sabira Legesse, Senior Associate Director for Ambulatory Care for the North Brooklyn Health Network, encompassing Woodhull and Cumberland, said, “We have seen improvement in hypertension and diabetes control that would not have been possible without PCMH. Overall the model has had a positive impact on patients and metrics have demonstrated that it is an effective method to enhance healthcare outcomes.”

The NCQA found that all three Brooklyn facilities have integrated the best elements of private practice in coordinating care and making care accessible including: implementing an on-call system where patients reach their doctor if situations arise that could affect their care; new care-management procedures to identify high-risk patients; referral tracking and follow-up; and supporting safe-care, and the ability to document and measure performance in meeting these goals. Other significant Patient-Centered Medical Home benchmarks to achieve the highest level of certification include:

  • Extended hours of operation beyond a 9-to-5 schedule, so patients can juggle appointments along with their real-life obligations. Providing expanded hours around patients’ schedules also helps to minimize unscheduled Emergency Room visits.
  • Greater availability for outpatient appointments, including same day appointments, so that if a patient has an urgent condition he or she can be seen promptly. This produces better service for patients as it is more likely they will receive treatment by a provider they know, and who is familiar with the details of their medical condition.
  • Developing a care team for each patient, which offers patients the reassuring experience of interacting with the same doctor or nurse at each appointment. This continuity of care enables patients to develop a relationship with providers who know their situation firsthand.
  • Tracking of patients during each step of their care by their care team who provide proactive intervention, not merely reactive treatment. If a patient is in need of a refill of their prescription, that can be handled through direct communication to their pharmacy, without an appointment, making it far easier and more convenient for the patient to adhere to their medication plan. The care team also makes pre-visit calls to ensure that a patient’s test or screening results have been received so the patient and their care providers can take action immediately on any medical issues, rather than wait until an office visit. By keeping track of patients who suffer from chronic conditions, managers are able to identify triggers and catch ailments before they spiral out of control.
  • Collaborating with patients on their self-management plans ensures that a personal connection is made between providers and their patients, so that care providers become familiar not only with a patients’ ailments, but with any barriers that may exist to successful healthcare outcomes. From medication reconciliation to education and guidance to nutritional counseling, a patient’s care team becomes the first line of defense for any condition.

“NCQA’s PCMH recognition shows that Coney Island Hospital has tools, systems and resources to provide our patients with the right care at the right time,” said Dr. John Maese, Chief Medical Officer at Coney Island Hospital. “It is a way of organizing primary care that emphasizes care coordination and communication to transform primary care into what patients want it to be.”


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