EmblemHealth Medical Home High Value Network Project
Program Location:
New York, NY
Number of Practices:
38
Payer Type:
Commercial
Payers:
EmblemHealth
Reported Outcomes
Description:
The EmblemHealth Medical Home High Value Network Project took place in New York from 2008-2010. Modeled on 2008 NCQA (National Committee for Quality Assurance) Physician Practice Connections-Patient-Centered Medical Homes (PPC-PCMH) guidelines, intervention practices received 18 months of tailored practice redesign support; two years of revised payments, including up to $2.50 per member, per month, for achieving quality targets; up to $2.50 per member, per month for PPC-PCMH recognition; and 18 months of embedded care management support. Controls received yearly participation payments.
** This program is no longer active
Payment Model:
Physicians participating in the pilot recieved $2.50PMPM with an opportunity to earn additional bonus payments.
Fewer ED / Hospital Visits:
-
3.8 fewer ED visits per year, saving approximately $1,900 in ED costs per physician, per year.
Improved Health:
Intervention physicians significantly improved two of 11 quality indicators:
- hypertensive blood pressure control over two years (23 percentage point improvement in the intervention group, versus a two percentage point increase in the control group)
- breast cancer screening over three years (3.5 percentage point improvement in the control group, versus a 0.4 percentage point decrease in the control group.)
Data Source(s):
Last updated March 2019
