Primary Care

Grantee Name

New York Health Plan Association Council, Inc.

Funding Area

Primary Care

Publication Date

June 2014

Grant Amount

$353,949

Grant Date:

November 2007 – August 2010

A landmark study found that patients receive appropriate care only 50% of the time for many illnesses.

Treatment errors contribute to needless injuries and deaths and high costs in the health care system. As a result, public and private purchasers have been motivated to institute pay-for-performance programs. These programs give financial incentives for safe, effective, timely, and patient-centered care that focuses on the transparency of quality services.

In 2007, the New York Health Plan Association (HPA) set out to partner with the New York Business Group on Health, the P2 Collaborative of Western New York, several health plans, and individual physician practices to provide them with access to Healthcare Effectiveness Data and Information Set data, which measures performance on care and service.

To further support efforts to measure and reward quality care, the New York Health Foundation (NYHealth) awarded HPA a grant to create the New York Quality Alliance (NYQA) Physician Portal, which built on NYQA’s measurement, reporting, and pay-for-performance initiative.

Outcomes and Lessons Learned

  • Engaged the Health Information Exchange of New York (HIXNY) to assume a lead role on the project when HPA was unable to execute a contract with P2 Collaborative. HIXNY recruited physicians from CapitalCare Medical Group to participate;
  • Worked with its member plans—Capital District Payment Health Plan, MVP Health Care, and   HealthNow—that agreed to participate and accepted corrected information from participating physicians;
  • Developed a physician portal that allowed for the review of and corrections to source data, which was used by 50 physicians recruited to participate; and
  • Generated physician quality measurement scores based on the review and correction of source data through the portal.

Of those who participated, 48% responded that the NYQA portal met their needs, almost 29% said that it did not meet their needs, and 24% responded that it only partially met their needs with data accuracy being the main issue.