The Adirondack Health Institute (AHI)
Medical Home in Glens Falls is one of five
Multi-payer Advanced Primary Care Practices
(MAPCP) demonstrations nationwide
to receive an extension by Centers for Medicare
& Medicaid Services (CMS).
The extension runs through Dec. 31,
2016.
Launched in 2011, the Adirondack
Medical Home was a five-year pilot study.
The health care goals included improving
quality, ensuring access and containing
costs. The emphasis continues to be on
preventive care, enhanced management of
chronic conditions, and the assurance of
a close relationship between patients and
their primary care providers.
Jason Helgerson, New York state medicaid
director, recently praised Adirondack
Medical Home’s national success at a statewide
meeting.
“They (AHI) have been actively involved
in one of the nation’s most successful
patient medical-home pilots that brought
together a whole array of providers who
have actively participated in the Medicaid
program,” he said.
Bob Cawley, AHI’s Medical Home initiatives
director, presented its successful
implementation strategies to multi-stakeholder
representatives of the Comprehensive
Primary Care (CPC), a national medical
home initiative.
“We wanted to invite AHI because of
their recognized national success status,”
said Lisa Dulsky Watkins, director, Milbank
Memorial Fund Multi-State Collaborative,
the convener of CPC and MAPCP forums.
“They serve as exemplars for our program and we felt it was important to benefit from
lessons learned.”
The Adirondack Medical Home is a collaborative
effort by health care providers
and public and private insurers to transform
the health care delivery system in a rural,
upstate New York region. Forty-one practices
in the Adirondack region (Clinton,
Essex, Franklin, Hamilton, Warren, and
Washington counties) currently participate
in the Adirondack Medical Home initiative.
The traditional health care model
(known as “fee for service”) pays physicians
for the volume of claims submitted, instead
of the results of their care. Important
preventive care is often not reimbursed
or underpaid, so patients end up getting
treated only when a disease or complaint
becomes severe. There are also no incentives
for coordination of care and managing
chronic conditions.
“The Adirondack Medical Home shifted
the focus to preventive care and health
maintenance,” said Cawley. “The pilot
created funding incentives that rewarded
keeping people as healthy as possible rather
than paying for procedures without regard
to effectiveness. This approach allows
patients to stay healthier and doctors to
concentrate more on quality of care rather
than volume of care.”
On the patient side, officials said increased
contact with the primary care
practitioner enables earlier diagnosis and
prevention of problems. Early diagnoses
generally translate into better health and
lower costs.
For more information, visit www.adkmedicalhome.org.