A recently published case study details the early days of the Adirondack region’s transition to a medical home and provides a guideline for primary care practices to achieve a value-based delivery model.
The medical home model places an emphasis on preventive care, enhanced management of chronic conditions, and the assurance of a close relationship between patients and their primary care providers and is regionally administered by an AHI program, the Adirondack Medical Home Initiative (AMHI). AMHI is a collaborative effort by health care providers and public and private insurers to transform the health care delivery system in six Adirondack counties – Clinton, Essex, Franklin, Hamilton, Warren, and Washington. The goal is to ensure quality, accessible care while working to contain costs.
AHI Director of Health System Transformation, Bob Cawley, was one of several partners interviewed by PartB News Online, a subscription publication targeting providers. The resulting case study titled Lay the Groundwork for a Successful Medical Home Transition details the Adirondack region’s transition to a medical home model, providing practices with the steps needed to create a value-based delivery model.
“The key step is to prepare for negotiations with payers,” said Cawley. “We have seven commercial plans plus Medicaid and Medicare in our region. Our negotiations centered on what it would take to become a medical home.” The case study shared examples such as IT infrastructure and care management workforce.
In the Adirondack region 100+ primary care providers, five hospitals, and seven health insurance organizations are working together to develop an innovative, patient-centered model of health care that strengthens the role of primary care. The size and scope of the practice is an important factor. In the Adirondack region, joining the practices to speak with one voice provided pivotal. “None of the practices had the critical mass to really get the attention of any given payer,” said Cawley.
Partners in the region joined together seven years ago and the resulting medical home is considered a success. “The first couple of years were tough,” said Karen Ashline, assistant vice president, Adirondacks ACO, a partner organization. “I think we’ve placed ourselves well for some of the next steps around value-based purchasing and really focusing on high-quality first,” says Ashline.
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