Reaching Excellence Together
Create Improvement Incentives
Ultimately providers must function within the system they have inherited. Thus, performance on indicators for top community priorities in Western New York are tied to the structure of the regional and national health system - a broad and complex network of health policies, payment structures and legislative context. Reorienting the system around the needs of the patient requires first an appreciation that this approach pays, in terms of stronger outcomes and with respect to lower costs. In a fragmented system that rewards quantity over quality, costs has spiraled to unsustainable levels without parallel improvement of outcomes.
With some in the beginning stages, Western New York health plans should continue exploring options for tying provider reimbursement levels to the delivery of patient-centered care, including compassionate care, coordinated care and fluid, effective communication. Along the same lines, hospitals and clinical plans could tie staff compensation to patient satisfaction on related indicators. Efforts should also align with national efforts for reform to leverage available resources.
National Best Practice
Patient-Centered Medical Home
What if your personal doctor knew your entire health history and family background, was accessible at all times, and coordinated a team of your doctors in the interest of getting you the care you need when you need it most?
Gaining momentum across the nation is a medical practice model committed to patient-centered while generating positive clinical outcomes. In response, insurers are changing their reimbursement models to reward practices for transforming into medical homes. For instance, among the many pilot programs across the country is the state of Colorado's program for family medicine residencies. As part of this program, five of the state's largest health insurers have developed a reimbursement policy rewarding the patient-centered model. The hallmark of the medical home is team-based care providing continuous, coordinated care. The model leverages health information technology to support open patient-provider communication, preventive care and operational efficiency at the practice level.
Local Best Practice
WNY Health Care Providers Piloting Medical Home Concept
Spurred by the Alliance of Community Health Plans' national push to test the patient-centered medical home model, several health plans in Western New York are in the midst of major piloting efforts.
Among them are 140 physicians at 23 practices working with Independent Health, and 33 physicians at six practices within CIPA WNY IPA Inc., a partnership between the Catholic Health System and a network of associated physicians.