Upstate New York and New York City
Upstate New York is one of the original Bridges to Excellence pilot markets and has been active since 2004. Since that time, the market and the participating practices have made significant improvements in the care that is delivered. These improvements were motivated and achieved through the BTE collaborative effort and dedicated participation by all stakeholders. What is critical to note is that the improvements impact not just the employees of the participating employers, but all patients that visit the recognized physicians and practices. Some of the best examples of practice transformation come from the Upstate NY region. For example, large multi-specialty practices have instituted diabetes improvement programs, comprehensive patient education, and support and care management programs. Upstate NY will continue to build on that success and look to expand BTE participation to new purchasers, employers, coalitions, health plans and providers.
Downstate in New York City, BTE is collaborating with the NY City Department of Health and Mental Hygiene (NYC DOHMH) in an effort to create a city-wide implementation that would capitalize on the Department's Primary Care Information Project (http://nyc.gov/html/doh/html/pcip/pcip.shtml). The goal is to harmonize a core set of performance measures in NYC around the Take Care NY program that will form the basis for BTE's recognition programs. The NYC DOHMH and BTE have started a series of conversations with NYC-based health plans, including Wellpoint, Emblem, Aetna and CIGNA, and will continue to work with those plans to tie physician incentives to BTE recognitions achieved by physicians in NYC through this collaborative effort. All physicians in NYC will have an opportunity to participate in the effort if they have a means to report their performance data electronically to the TCNY measures database. Current partners also include the NY State Medical Society.
QUICK MARKET FACTS
Number of Recognized Physicians:
381 in Upstate NY
Rewards Paid to Date:
$1.7 million since 2004 (in Upstate NY)
BTE Programs Implemented:
Physician Office Link, Diabetes Care Link, Cardiac Care Link
Geographic Scope of Market:
Select NY counties for Upstate NY*
Number of Covered Lives in Market:
44,000
Participating Employers:
General Electric
,
Golub Price Chopper
,
Verizon
Licensed Health Plan Administrators:
CDPHP
,
MVP Health Plan
Performance Assessment Organizations and Measures:
National Committee for Quality Assurance (NCQA), IPRO (POL Only)
Reward Amounts:
| Recognition |
POL |
DCL |
CCL |
| Level I |
$15*
|
$80
|
$80
|
| Level II |
$30*
|
N/A
|
$160
|
| Level III |
$50*
|
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