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Expanding Primary Care Capacity in the North Country

  • By: NYSHealth
  • Date: January 2017
  • Priority Area: Advancing Primary Care
  • Type: Grant Outcome Reports
  • Category: Grant Outcome Report
  • Grantee Name: Hudson Headwaters Health Network

Overview

The rural communities in the Adirondack region of upstate New York’s North Country lack widespread access to comprehensive primary care services. This lack of access can result in poor health outcomes, high rates of chronic disease, and increased emergency room visits and hospitalizations. Hudson Headwaters Health Network (HHHN), a federally qualified health center and the North Country’s largest medical group practice, and University of Vermont Health Network (UVMHN), a multihospital organization serving all of Vermont and parts of northern New York, explored partnership opportunities to improve primary care access and capacity in the region. NYSHealth awarded HHHN a grant to support the development of a partnership with UVMHN that would best serve the needs of North Country residents. The project explored the governance, financial, and legal factors and implications of the partnership for the provision of primary care to 15,000 new patients in the area, of which up to 60% were uninsured or covered by Medicaid.

Grantee: Hudson Headwaters Health Network

Dates: March 2015 – December 2015

Grant Amount: $60,800

Grantee Website: http://www.hhhn.org

Grant ID: 14-03196


Outcomes and Lessons Learned:

  • Addressed a range of considerations specific to primary care capacity building, such as governance, financial arrangements, physician recruitment, academic and teaching programs, and regional project planning;
  • Outlined the role of each organization in increasing primary care access and capacity, improving quality of care, recruiting and retaining primary care physicians, and establishing primary care practices across the region;
  • Examined the legal and regulatory requirements needed to formalize a partnership between a New York-based primary care network and a Vermont-based medical center; and
  • Negotiated a plan that was financially and operationally viable for both organizations.


HHHN and UVMHN also entered into two agreements that went beyond the grant’s original set of expectations and represent a major contribution to regional collaboration. UVMHN agreed to sell 50% of its membership in the Adirondack Accountable Care Organization to HHHN, which includes more than 450 participating primary and specialty care clinicians throughout northern New York. Recognizing that HHHN would incur additional costs in developing additional infrastructure to serve the North Country, UVMHN also agreed to provide a grant to HHHN to support the expansion of jointly operated facilities throughout the region. And in support of the goals of the Delivery System Reform Incentive Payment (DSRIP) program, New York State is awarding grants to improve health care in the North Country, of which HHHN is a recipient. As a result, HHHN will receive $7.3 million in funding from UVMHN and the State to develop a new joint-practice facility in the City of Plattsburgh. HHHN also is using the joint planning process for developing future facility options in two communities already served by HHHN: Ticonderoga and Champlain. It is stipulated that each facility will include space for behavioral health and care managers and for the co-location of specialty and ancillary services as identified in the joint planning process. All new sites also will host primary care residents from UVMHN’s new family medicine residency programs, with the hope to alleviate some of the primary care recruitment and retention deficits that are common in rural areas of New York State.

Co-Funding and Additional Funds Leveraged: NYSHealth support for this project led to a $4.3 million grant from UVMHN and a nearly $3 million grant from New York State for the establishment of the first federally qualified health center in Plattsburgh to be jointly run by UVMHN and HHHN.