DSRIP Year 3: Shifting from Pay for Reporting to Pay for Performance
On April 1, with the start of DSRIP Year 3, the shift begins to Pay for Performance from Pay for Reporting. To date, network PCPs primarily have reported on and been rewarded for patient engagement, such as lifestyle modification counseling, providing an Asthma Action Plan, or making a smoking cessation referral.
Going forward, DSRIP payments increasingly will be based on ACP’s ability to achieve clinical and patient-centered quantitative outcomes.
Pay for Performance: Clinical Measures
Although DSRIP will continue to reward for Engagement (e.g., depression screening and lifestyle modification), on April 1, 36 measures become related to performance, including:
Access to Care, includes such measures as Children’s Access to Care at various age ranges (e.g., 12 to 24 months, 12 to 19 years).
Utilization, including Potentially Preventable ED Visits and Potentially Avoidable Readmissions.
Medical Management, which encompasses measures such as Asthma Medication Ratio.
For the first time, patient satisfaction will be a factor, based on results of CAHPS (Consumer Assessment of Healthcare Providers and Systems) surveys that assess the patient experience of care, including:
Access to timely appointments, care, and information
How well providers communicate with patients
For DSRIP purposes, a CAHPS questionnaire is sent annually to a random sample of 1,500 ACP patients. The survey is mailed, with follow-up by telephone for those who don’t return the printed survey. Questions fall into four “composite” categories:
Provider rating: 5 measures (e.g., care coordination)
Access to primary care: 2 measures (e.g., “provider is usual source of care”)
Health literacy: 3 measures (e.g., provider usually or always gave easy to understand instructions for caring for illness or health condition)
Effectiveness of care: 6 measures (e.g., had a flu shot or flu spray)
To ensure positive CAHPS survey results, practices should focus on physician and staff training, implementation of PCMH, and health literacy strategies such as “Teach Back” and “Ask Me 3.”
Drivers of Quality, Risk Scores and Medical Spend.
There are steps every practice can take to impact quality and risk scores and medical spend:
Claims and Encounter data are the basis for reporting.
Submit a detailed claim or encounter for every visit.
Each claim should permit a maximum number of Dx Codes.
Accurate and complete diagnosis codes are essential.
Convert Non-Users – capitated patients who have not had a visit in more than 12 months – to having at least one annual visit.
Remember, no claim, no encounter.
PCMH to track meaningful use.
DSRIP Network Is NOW OPEN for New Providers
The DSRIP PPS Network will be open for approximately 2 weeks to allow PPSs to add providers to their network.
Do you know a provider that would like to join ACP? Contact Luis Ramirez, ACP Director of Physician Engagement, at: 917-946-4812 or email@example.com.
ACP Celebrates $6 Million Disbursement to Network Physicians
ACP celebrated disbursement of implementation checks with personal visits to a few of our network physicians. ACP is distributing nearly $6 million to PCPs based on their engagement, reporting, and participation in ACP’s DSRIP projects, and an additional $3.24 million to other network partners, for a total of $9.24 million. Read our press release available in English, Spanish, and Chinese. To view Chinese media coverage of the events, click here.
Pictured: Alex Chan, Administrator, ECAP; Winnie Leung, Physician Engagement Manager, ACP; Dr. Yanfeng Chen, ACP Physician; Mary Ellen Connington, Chief Operating Officer, ACP; Dr. George Hall, ACP Physician; Dr. Henry Chen, President, ACP; Gloria Wong, Vice President of Operations, ACP; Dr. James Cai, ACP Physician
National Nutrition Month, celebrated all March long, focuses attention on the importance of making smart food choices and developing sound eating and exercise habits. Both the ACP blog and DASH-dedicated Food as Medicine blog feature brand new nutrition posts that make it easy to make better dietary choices.
"Taking control of your diet and your health may be as simple as focusing on just 10 foods and nutrients."
Educating NYC on DASH
ACP has been on the move, hosting hands-on training and food demonstrations around New York City. ACP Director of Integrated Outreach Denisse Oller and the ACP Community Engagement team were present at the American Diabetes Association's NYC Diabetes EXPO, where Denisse served as Emcee and a host for the healthy eating stage.
ACP also joined Hostos Community College for their annual wellness festival. Denisse and ACP Community Engagement Manager Adriano Espaillat were interviewed by The Bronx's News 12 on easy ways to stay healthy. Watch the video here.
ACP is Hiring!
ACP is growing, and we are pleased to invite qualified job seekers to apply for open positions. We are seeking high-energy, community-minded individuals who are passionate about making a difference in the lives of other New Yorkers. Many of our physicians and their patients are immigrants, so a second language (especially Spanish or Chinese) is a plus.
Cultural Competency and Health Literacy Project Specialist
The CCHL project specialist will assist the independent practices on increasing their operations to address issues of communications between patients and providers to solidify the patient-centered approach and value-based payments structures that DSRIP aims to achieve.
To apply, please attach your resume by email to Liz Webb at firstname.lastname@example.org and indicate the title of the position(s) you are applying for in the subject line.