PLATTSBURGH — The Adirondack Region Medical Home Pilot Program received a big boost Tuesday when officials learned that regional doctors will now be reimbursed for treating Medicare patients.
The program, which emphasizes improved quality care for patients while reducing the overall cost of medical care, is one of only eight such programs across the country to be chosen for Medicare funding.
'BIG BENEFIT'
Until now, doctors participating in the Medical Home Program received an additional reimbursement fee only for patients with private insurance and for those covered with Medicaid.
"This represents a big benefit for the physicians in our region," CVPH President and Chief Executive Officer Stephens Mundy said Tuesday.
"For many of our internists and family physicians, half of their patients are covered by Medicare, and they were not being covered under the Medical Home Pilot."
Regional doctors were treating Medicare patients and were being reimbursed the standard fees for those patients. But Medicare's involvement in the program will enable doctors to receive additional fees targeted toward improving patient services.
'WONDERFUL NEWS'
"Anything the government does that will increase the quality of patient care that we are allowed to deliver will be positive, particularly in our rural region," Dr. Debra Clark, president of the CVPH medical staff, said in a news release Tuesday afternoon.
Primary-care physician Dr. David Anderson echoed those thoughts.
"This is wonderful news for primary care in the North Country and eventually for primary-care physicians across the United States. It will help to attract more primary-care doctors to the field. The current shortage is of great concern to our nation."
LARGEST PILOT
The Adirondack Region Medical Home Pilot, stretching from the Canadian border south to Glens Falls and west to Saranac Lake, began eight months ago as the nation's largest Medical Home pilot, based on the number of participating providers and geographic size.
The New York State Department of Health was a major factor in creating the Adirondack program as one of a half-dozen pilots in the state. The Health Department was also instrumental in submitting the Adirondack Region pilot for consideration by Medicare.
MEETING THE MARK
As part of the Medical Home Pilot program, physicians have to meet certain requirements. For instance, one regulation required that 80 percent of the region's participating physicians incorporate electronic prescription services into their practice by August 2010.
By that date, 99.2 percent of the physicians were offering electronic prescriptions, Mundy noted.
Doctors also have to submit a detailed application by February 2011 that shows they have reached several standards of patient care.
Many have already reached those standards, Mundy added.
The Medical Home Pilot emphasizes the need for improved coordination of care and management of chronic conditions, such as obesity, heart disease and diabetes, and improved communication between doctors and their patients.
CHANGING THE SYSTEM
"The Adirondack Region Medical Home has been recognized as an innovator that will change how our health-care system works — putting patients first," said U.S. Sen. Charles Schumer in a press release.
Adirondack Medical Center President and CEO Chandler Ralph called the Medicare decision a "historic moment" for the region's Medicare patients.
"The fact that (the Center for Medicaid and Medicare Services) stepped forward and recognized the unique rural nature and success of our Medical Home project speaks volumes about the hard work done by physicians, hospitals, insurers and New York state in bringing this project to fruition," she said.
Both Mundy and Ralph praised the work of Schumer, Sen. Kirsten Gillibrand and Congressman Bill Owens for their work in supporting the regional health-care pilot.
E-mail Jeff Meyers at: jmeyers@pressrepublican.com
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