Proposal for Adirondack Medical Home Pilot

From the NY State DOH: The State Health Commissioner Richard Daines, M.D., joined representatives of health care networks, hospitals, health insurance plans and primary care advocates today in Plattsburgh to
continue development of a new model of health care that will benefit both
patients and providers in the Adirondack region.

The Adirondack Region Medical Home Pilot, developed by a group of
local health care providers and other partners, would receive $4.5 million
over two years through enhanced Medicaid reimbursement in Governor David A.
Paterson’s proposed budget. Providers would also benefit from enhanced
reimbursement from the Empire Plan, the state employees health insurance
program, and several commercial health plans expected to participate.

In return for the enhanced reimbursement, participating health care
providers must meet a new standard of care that provides increased emphasis
on primary and preventive care, improved coordination of care and
management of chronic diseases, improved communication with patients –
including patient reminders for check-ups and screenings – the use of
electronic health records and electronic prescribing, and adhering to
quality and safety standards.

“Too many New Yorkers develop serious health conditions and
complications because they are not getting the kind of health care that
prevents and manages those conditions before they become serious,” said
Commissioner Daines. “As a result, we have poorer health and a
higher-than-average number of hospitalizations for preventable conditions,
which also increases the cost of health care. The Adirondack Region Medical
Home Pilot represents a new way of delivering health care with an emphasis
on primary care that will improve the health of residents and ultimately
reduce the cost of health care.”

Dr. Daines noted that the enhanced reimbursement provided to doctors
in the Medical Home Pilot will also help Adirondack communities recruit and
retain physicians.

“Governor Paterson recognizes that New York’s rural communities have
a more difficult time attracting and keeping physicians,” said Dr. Daines.
“That’s why he supported the Doctors Across New York program that provides
loan forgiveness and practice support for physicians practicing in
underserved areas and in part why he is supporting the Adirondack Regional
Medical Home Pilot.”

“Patients, primary care physicians, insurers, and the health-care
delivery system will all benefit from the Adirondack Region Medical Home
Pilot,” said Stephens Mundy, president and CEO of Champlain Valley
Physicians Hospital (CVPH) in Plattsburgh, which hosted today’s meeting.
“CVPH and its participating physicians are pleased to be part of this
revolutionary approach to shaping the future of how medical care is
provided.”

“The Adirondack Region Medical Home Pilot is a bold effort to prove
on a reasonably large scale that giving more attention and resources to
primary care is our best bet for keeping down medical costs while also
improving health,” said John Rugge, M.D., CEO of Hudson Headwaters Health
Network, an early leader in the development of the medical home project.

Senator Betty Little said, “A proactive approach emphasizing
prevention and early intervention is the key to strengthening the health
care system and reducing cost. I can think of no better place than the
Adirondacks to launch this pilot program. We have a dedicated group of
health care professionals who time and again have shown an extraordinary
ability to overcome the unique challenges of providing care in a rural
setting. This is an exciting opportunity for us and I thank Governor
Paterson and Commissioner Daines for making this smart investment.”

Assemblywoman Teresa R. Sayward said, “It is gratifying to see
Governor Paterson and Commissioner Daines working with our North County
healthcare providers to strengthen the availability of services to meet the
health care needs of our rural residents.”

Assemblywoman Janet L. Duprey said, “I am pleased that Governor
Paterson recognizes our unique needs in terms of quality health care
delivery in the North Country. My thanks to Commissioner Daines for his
insights and for carrying this critical issue to Albany’s attention. This
is truly another positive step toward promoting easy access, coordination
of care, quality services and cost effective health care to our residents.”

“County leaders applaud Governor Paterson for recognizing the unique
needs of rural health care in the Adirondacks and his commitment to ensure
that every family in this state, no matter whey they live, has access to
the services they need to stay in good health,” said Stephen J. Acquario,
Executive Director of the New York State Association of Counties (NYSAC).
“Access to quality health care is essential to all New Yorkers, and it is
critical to the long-term viability of any community. Our counties have
seen first-hand the need to address the issues compromising access to
primary health care in the Adirondacks and other rural areas of the state.”

The Medical Society of the State of New York (MSSNY) is providing
technical assistance for the health information technology component of the
Adirondack Medical Home Pilot. “The Medical Society is greatly appreciative
of the leadership of Governor Paterson and Commissioner Daines to advance
the adoption of health information technology,” said MSSNY Presdent Michael
H. Rosenberg, M.D. “MSSNY is pleased to participate with physicians in the
Plattsburgh, Saranac Lake, and greater Adirondack regions to facilitate the
use of this technology in the implementation of a patient centered medical
home demonstrations that will assure greater care coordination, enhanced
quality, and improved outcomes for patients.”

“Everyone talks about how the current health care system is broken
and needs to be fixed,” said Rod Boula, CEO of Elizabethtown Community
Hospital in Essex County. “This is one way of being part of the solution.
This is a program where everyone wins. Moreover, our hospital will be able
to recruit primary care physicians who want to come here to practice
medicine, earn a decent salary, and raise their families.”

“Because of the current crisis in primary care and well-documented
physician shortage in rural New York State, a new model is being proposed
to support primary care,” said Bill Viscardo, M.D., Vice President for
Medical Affairs at the Adirondack Medical Center in Saranac Lake. “The new
model is the medical home, which promises increased access to care for
patients and increased reimbursement for primary care physicians.”

Nancy G. Groenwegen, President of the New York State Civil Service
Commission, said, “Representing the State as the largest employer in the
region, and as a large purchaser of health care for our employees and their
dependents, the Department is pleased to support the Adirondack Medical
Home Pilot. Governor Paterson has made it clear that reducing unnecessary
costs in our employee benefit programs is a priority. We understand that
improved access to high-quality, patient-centered primary care will, in the
long run, reduce unnecessary complications of chronic diseases and will
thereby reduce the long-term cost of providing health insurance to our
employees. This pilot, if successful, will confirm that relatively small
investments in primary care now, can add tremendous value by helping to
reduce catastrophic costs later.”

Medical Home Facts

The Adirondack Region Medical Home Pilot will provide a new model for
the delivery of health care services that emphasizes the role of primary
care. The pilot is expected to improve access to services, improve the
quality of care, and lower costs over the long-term.

Under the pilot, primary care providers in the Adirondack Region of New
York State will receive increased reimbursement in exchange for expanded
responsibility for coordinating care, providing preventive care and
managing chronic diseases. The increased reimbursement is expected to be
offset by decreased costs from fewer hospital admissions, less frequent
referrals to specialists, lower prescription costs, and overall better
health.

Pilot participants are expected to include health care providers in 35
practices (representing 101 physicians and 76 physicians assistants and
nurse practitioners), four hospitals, six commercial health plans and
Medicaid, the State of New York, the Medical Society of the State of New
York, and the New York State Association of Counties.

The New York State Department of Health will provide supervision and
arrange for ongoing evaluation of the program.

The pilot is scheduled to begin in July 2009.

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