Physician Support and Recognition

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A True Partner To Our Provider Community

As a health plan founded and directed by physicians, CDPHP always strives to be a true partner to our provider community, listening to their needs, keeping them informed of changes that impact their practice, providing education, easing administrative burdens whenever possible, and celebrating their accomplishments. Perhaps that’s why overall provider satisfaction with CDPHP remained high in 2019 and was trending upward, with 96 percent of survey respondents reporting being very satisfied or satisfied. Listed below are some of the initiatives that might have contributed to that positive response from our provider partners.

Reducing Administrative Burdens

As a part of our ongoing effort to make it easier for care providers to get their jobs done, CDPHP announced changes to our prior authorization policies in 2019. Effective January 1, 2019, CDPHP made the decision to remove eviCore as the gatekeeper of advanced radiology testing; in fact, we eliminated the prior authorization requirement for all high-tech radiology testing. Also, effective January 1, 2019, CDPHP removed the requirement to seek prior authorization for 11 other services.

Celebrating Excellence: Top Doctors

In September, CDPHP held its third annual Top Doctors celebration to honor local primary care doctors who have met our health plan’s rigorous standards for quality, efficiency, and patient satisfaction. The 2019 Top Doctors report lists the Capital Region’s top-performing primary care practices based on key performance data, as well as results from patient satisfaction surveys. New to the list this year were the People’s Choice Awards, which celebrate those practitioners and staff members nominated by their patients and peers.

Enhanced Primary Care (EPC) Program

Our Enhanced Primary Care (EPC) program continued to evolve in 2019. EPC is an investment in top-quality primary care that focuses on disease prevention and chronic care coordination. Instead of paying primary care practitioners just for episodes of care, the EPC program rewards them financially for their efforts to keep their patients well. EPC aligns financial incentives with specific goals focused on enhancing patients’ access to reliable, quality care; improving overall population health; and reducing the per capita cost of care.

In 2019, in addition to the 12 standard quality measures by which the performance of our EPC medical practices is gauged, we adjusted the quality metrics to include six new ones chosen by participating practices. This was a win-win for patients and physicians, especially for our internal medicine and family practice sites who participate in other value-based programs.

To ensure that CDPHP remains on the cutting edge of best practices and care innovation, we have recruited distinguished network physicians to serve on our EPC Advisory Panel. The panel’s quarterly meetings provide a forum for exploring new and ground-breaking enhancements to the delivery of care.

New Multi-Specialty Medical Office Facility

In September, CDPHP announced a partnership with several local, independent, physician practices to create a multi-specialty medical care center in Clifton Park, N.Y. The state-of-the-art, patient-centered facility will provide patients with the highest level of care and customer service, and will be run by some of the best doctors in the country. The independent physician partners include Albany ENT & Allergy Services, Albany Gastroenterology Consultants, Capital Cardiology Associates, Capital District Renal Physicians, and OrthoNY. While each practice will remain independent, the goal is to create a unified patient experience that will utilize the latest technology and forward-thinking business practices.

Provider Education

As a health plan founded and directed by physicians, CDPHP is always looking for new and innovative ways to support our provider partners with continuing education and enhanced service. Among the educational opportunities we sponsored in 2019 were:

  • No-Cost Customer Service Training for Medical Practice Staff. Our members’ experience of care is important to us, so as a service to our participating providers, CDPHP created a free, three-hour customer training program specifically geared to medical practice employees. The program presented customer-centered strategies for interacting with patients—even the difficult ones—in an effective and empathetic way.

  • A variety of webinars and seminars for primary care and behavioral health practitioners focusing on:

    • Eating disorders

    • Veterans’ combat-related mental health issues

    • Caring for patients with stress illness

    • Early-childhood screening for hearing loss, lead levels, and developmental delays

    • Medicaid managed care updates

    • Coding tips for meeting HEDIS quality measures

  • Sponsorship of the Sage College annual nutrition lecture, which this year addressed the symptoms of food intolerance and strategies for managing it.

Data Analytics and Back Office Support

Practice Support Services, LLC and its subsidiaries represent a unique collaboration between payer and provider, supporting the delivery of quality care and streamlining the administrative functions of medical practices. The company offers a full suite of clinical and back-office services, including access to data analytics and care management resources, as well as assistance with practice logistics like invoicing, collections, staffing, and more.

CDPHP Corporate Member Engagement

In 2019, CDPHP hosted a dialogue with its founders to discuss the issues affecting our Plan’s ability to deliver high-quality, affordable health care services, including the threats posed by single-payer health care, hospital/provider consolidation, rising drug prices, and physician shortages and burnout, among others. We also explored with them the changes in governance that might be necessary to allow for a more nimble response to changing trends in the health care industry. As a result of this dialogue, corporate members had an opportunity to reconnect with their peers and our corporate leadership team, and our corporate bylaws were amended to make it easier to interact with our physician partners in the current health care climate, as well as to attract and retain young physicians as Class B corporate members.