Introducing New York State Patient Centered Medical Home (NYS PCMH)

Are you aware of the changes to New York State’s Advanced Primary Care Program?   On April 1, 2018 the New York State Department of Health (NYSDOH), in collaboration with the National Committee for Quality Assurance (NCQA) launched an innovative model for primary care transformation known as the New York State Patient Centered Medical Home (NYS PCMH). This statewide, innovative advanced primary care approach is characterized by a systemic focus on high quality care, population health and integrated behavioral health.

The NYS PCMH Recognition Program, built upon the NCQA PCMH model, is exclusive to New York State and supports the state’s initiative to improve primary care and promote the Triple aim: Improving Health, Enhancing Quality, and Reducing Costs.

There are enhanced benefits and resources now available through the NYSDOH which include:

• Initial Recognition Fees at no cost to practices. NYSDOH will cover the first year NYS PCMH Recognition fee or the first NYS PCMH Annual Reporting fee. The practice is responsible for paying their Annual Reporting fee each year after earning NYS PCMH Recognition.
• Transformation Assistance. New York state contracted with 15 organizations that specialize in NYS PCMH transformation and provide technical assistance at no cost to participating practices. These entities provide step-by-step assistance in managing the transformation process and support the efforts of improving the patient experience.
• Enhanced reimbursement opportunities. Supplemental payments through state programs such as the Medicaid PCMH Incentive Program may be available to practices that participate in NYS PCMH transformation.  NYSDOH is also engaged regionally with commercial payers to implement voluntary, multi-payer value-based payment (VBP) arrangements to support practices that have not had these opportunities through previous transformation efforts.

NCQA and the NYSDOH have developed numerous resources to assist in your transformation journey. The following can be found on the nyacp.org website:

• NCQA NYS PCMH Release
• NYS PCMH Brochure
• NYS PCMH Recognition Pathway

More information on NYS PCMH program requirements and additional resources and benefits can be found on the NYSDOH website or the NCQA website.

“The project described was supported by Funding Opportunity Number CMS 1G1CMS331402 from the U.S. Department of Health & Human Services, Centers for Medicare & Medicaid Services.  The contents provided are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies.

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