Health Department, United Hospital Fund and Partners Release Joint Report on Small Primary Care Practices in New York City

Report details a shared-services model for small primary care providers

Small practices are essential to the success of Take Care New York 2020, the City’s comprehensive health blueprint for helping all New Yorkers live a healthier life

June 14, 2018 — The Health Department, United Hospital Fund (UHF) and their partners in the Population Health Improvement Program (PHIP) today released PHIP Small Practice Project, a report which focuses on the challenges small, independent primary care practices face in New York City. Forty percent of primary care providers in the city are independent practices with four or fewer health care providers, and they serve some of the city’s poorest neighborhoods. The report is intended to help these providers and their potential partners understand the economics of shared-service arrangements. It describes a business model in which small practices can share the cost of needed services – such as care managers, diabetes educators, and health information technology staff – that can enable them to better care for their patients, and reduce preventable hospital admissions. This shared-services model could enhance New York’s primary care system, which is an essential part of New York State’s health reform initiatives and vital for communities with high health disparities. Read the report (PDF).

“Small practices are a critical part of New York City’s primary care system, providing medical services to some of the city’s most disadvantaged and diverse communities, but they are at risk in our changing health care environment,” said Health Commissioner Dr. Mary T. Bassett. “This report describes and quantifies a novel approach — sharing services across small independent practices – that can help them continue to serve those communities.”

“Access to high quality healthcare is important for everyone, no matter who you are or where you live,” said Health Department First Deputy Commissioner Dr. Oxiris Barbot. “Health care providers in small independent practices serve New Yorkers in every community in the city, and this report details supports that can help these small practices succeed in the ever-changing landscape of healthcare reform.”

“The medical home is a promising model to improve primary care delivery, produce better patient outcomes and address health inequities, and New York State is a national leader in the adoption of this model,” said UHF President Anthony Shih, MD, MPH. “This report describes and quantifies a new approach that could help small practices join in this evolution in primary care delivery.”

"The lack of access to primary care services continues to negatively impact the health outcomes of New Yorkers, especially in low-income neighborhoods such as the ones I represent," said New York State Senator Gustavo Rivera. "The PHIP Small Practice Project report aims to address this long-standing issue by providing practical solutions to independent primary care providers that could allow them to improve how they deliver care for their patients, and reduce the number of hospitalizations. Through innovative and collaborative strategies, such as the proposed shared-service model, providers will be able to reach out more efficiently to our city's most financially burdened residents and bridge the health disparities that continue to plague our borough."

The PHIP report offers New York City's small, independent primary care providers a framework for considering shared services as a way to access the new capabilities and staff they need but cannot afford on their own. Over the past 18 months, PHIP has worked with small practices across New York City to better understand their needs and assess the viability of a shared-services model, with a focus on the new skills required. The potential costs and value of such arrangements were also calculated.

The report covers four topics:

  1. How a small practice can shift from fee-for-service payments to payments that reimburse based on quality of care.
  2. How some organizations across the State are providing a range of services to groups of small primary care practices.
  3. What a fully-developed shared-service program might look like, the range of services that it might include, and the related costs.
  4. The legal and regulatory issues providers need to consider in crafting shared-services arrangements.

The report can be downloaded for free from the NYC PHIP Advance Primary Care Group website and from the UHF website.

About Take Care New York 2020 (TCNY 2020)
Launched in 2015, Take Care New York 2020 (PDF) is the City’s blueprint for giving every New Yorker the chance to live a healthier life. Its goal is twofold — to improve every community’s health and to make greater strides in groups with the worst health outcomes, so that the city becomes a more equitable place for everyone. TCNY 2020 aims to promote healthy childhoods, create healthier neighborhoods, support healthy living, and increase access for quality care.

About the Population Health Improvement Program (PHIP)
In January 2015, the Fund for Public Health in New York joined in partnership with the New York City Department of Health and Mental Hygiene, United Hospital Fund, and The New York Academy of Medicine to launch the New York City Population Health Improvement Program (PHIP). The NYC PHIP is one of 11 PHIPs created around the State, with funding from the State Department of Health, working to achieve inclusive health planning at the regional and local level. The PHIP will promote health equity for New Yorkers, as well as the “Triple Aim” of better care, lower health care costs, and better health outcomes.

About United Hospital Fund (UHF)
United Hospital Fund works to build a more effective health care system for every New Yorker. As an independent, nonprofit organization, UHF analyzes public policy to inform decision-makers, find common ground among diverse stakeholders, and develop and support innovative programs that improve the quality, accessibility, affordability, and experience of patient care. For more information about UHF’s initiatives and programs click here.

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MEDIA CONTACTS: Christopher Miller/Danielle De Souza (Health Department),
(347) 396-4177, PressOffice@health.nyc.gov

Catherine Arnst (UHF), (212) 494-0733, carnst@uhfnyc.org