NYS and AHI seek to enroll primary care practices that…
- want to prepare for major payment changes
- use a 2014 Certified Electronic Health Record (EHR)
- are not currently participating in a Medicare Shared Savings Program, Pioneer ACO program, Multi-Payer Advanced Primary Care Program, or Comprehensive Primary Care Initiative
What is Advanced Primary Care (APC)?
An investment of $67 million in federal resources to assist primary care practices to transform to highly-integrated, team-based models relevant to advanced primary care.
Through a vetted set of milestones and transformation support, practices can achieve an ideal blend of consistency, flexibility, goal-setting, leadership, implementation of workflow changes, and improve outcomes consistent with Value-based Payment (VBP) arrangements.
The APC milestones are defined as a core set of capabilities acquired over time in the following areas: Patient-Centered Care, Support/Promotion of Population Health, Care Management/Coordination, Access to Care, Advanced use of HIT, Readiness for Alternative Payment Models, and Quality Performance and Improvement.
Each of the three (3) “gates” denotes progress in levels of competencies achieved in each of the milestones.
Why does this matter?
- Medicare, Medicaid, and commercial health insurance providers are changing how they pay health care providers.
- Reimbursement is moving away from fee-for-service to new models that emphasize performance on quality measures, clinical outcomes and cost savings.
- There is also a restructuring underway of the various incentive programs. Performance on quality measures, including clinical outcomes, will determine reimbursement levels.
- Transitioning a practice through the Transforming Clinical Practice Initiative (TCPI) will result in significant benefits as reimbursement becomes more and more quality-based.
Benefits to Practices
Increase clinician and staff member satisfaction.
Participate in new payment/reimbursement models.
Improve practice efficiency.
Improve clinical efficiency.
Integrate the care management function into your practice.
Concrete opportunities for improvements in patient care.
Maximize the practices’ health information technology investment and use of EHR data.
Benefits to the Patient
- Systematic inclusion of patient and family engagement and patient self-management support.
- Better coordinated, more comprehensive, and personalized care leading to better outcomes.
How will AHI help?
- Coaching and guidance related to transformation.
- Skilled transformational assistance provided through a combination of remote and on-site training and support.
- Access to a faculty of nationally-recognized experts and online modules (providing CME and MOC credits) related to the transformation process.
- Services include, but are not limited to, assistance with maximizing incentives from payer contracts, avoidance of penalties, care management, quality improvement, networking, and more.