Physician Support and Recognition

CDPHP supporting physicians

As is befitting for a health plan founded and directed by physicians, CDPHP takes seriously its responsibility to network providers. Our aim is to understand and respond to their needs, provide important information impacting their practice, alleviate administrative burdens when possible, provide opportunities for education, and recognize their accomplishments.

COVID-19 Relief Measures

The coronavirus crisis created financial hardships for many, including our members and providers. Accordingly, we took steps to alleviate some of the financial burden of the pandemic.

  • Suspension of Prior Authorization. To relieve administrative burden for providers during the pandemic, CDPHP temporarily suspended all prior authorizations for medical and behavioral health services (excluding pharmacy services) for all members, with the exception of those enrolled in self-funded groups. The change applied to most inpatient medical and behavioral health services; scheduled surgeries and admissions; concurrent and retrospective review for inpatient services; hospital discharge planning, home health care, and inpatient rehabilitation services; and most outpatient services.

  • Support for Essential Workers. The COVID-19 crisis had an immeasurable impact on front-line workers such as health care workers, first responders, and all other employees deemed essential. In May 2020, the Department of Financial Services (DFS) issued an emergency regulation removing all cost-share for essential employees seeking outpatient behavioral health care services with in-network providers, a waiver that has been extended by CDPHP through July 1, 2021.

  • Telehealth Cost Waivers. In 2020, CDPHP encouraged the use of telehealth/telemedicine as a first line of defense and a way of improving access to care while minimizing the risk of exposure to the COVID-19 virus. All out-of-pocket costs for telehealth/telemedicine visits were waived for our members, including co-pays, co-insurance, and deductibles.

CDPHP also waived cost-share for all coronavirus-related testing and treatment, as well as telemedicine services provided by in-network providers, until early summer 2021.

Top Doctors 

For the fourth consecutive year, CDPHP released the 2020 Top Doctors Report, its recognition of local primary care doctors who have met our health plan’s rigorous standards for quality, efficiency, and patient satisfaction based on key performance data and results from patient satisfaction surveys. The report honored doctors in the following categories: Top Performers in Quality and Access; Top Performers in Diabetes Care; and Frontline Heroes: The People’s Choice Awards. Nominated by their patients and peers, the Frontline Heroes were recognized for showing exceptional compassion, care, and concern in the midst of a global pandemic.

Enhanced Primary Care

While we know that our Enhanced Primary Care (EPC) program has had a positive impact on the quality of care delivered to our members, the program has also been beneficial for our EPC providers. In addition to increased funding support, EPC has resulted in fewer administrative burdens for medical practices, greater administrative support in meeting the health care needs of patients and closing gaps of care, and, we hope, a decreased tendency for provider burnout. 

What was not immediately evident until recently was that the EPC program would also help insulate most participating providers from the severe economic ravages brought about by COVID-19-related declines in caseloads. Throughout the pandemic, CDPHP has continued to invest in our physicians.  Indeed, in contrast to traditional fee-for-service practices, EPC practices had a considerable financial cushion, with CDPHP paying $6 million more in global payments to support high-quality care, and $1 million less in fee-for-service payments.

Educational Opportunities  

CDPHP is always looking for new and innovative ways to support our provider partners with continuing education, including training sessions and lectures. Although the pandemic required transition to virtual programming in some cases, we were still able to offer:

  • “White Glove” Customer Service Training. To support the efforts of our network physicians and to ensure that patients have a positive experience when receiving care, the CDPHP Enterprise Training team offers free, monthly, virtual “White Glove” leadership and customer service training classes for area providers, their management staff, and office personnel.

    The leadership training session, geared exclusively for providers and practice management staff, focuses on hiring best practices, workplace change management, peer coaching, and quality assurance. The customer service training for office staff focuses on effective and empathetic communication and positive strategies for interacting with clients/patients in a variety of circumstances.

  • Clinical Lectures/Training. Before the pandemic brought a halt to in-person sessions, CDPHP sponsored a lecture on amyloidosis, an often-undetected disease that is being recognized as a major cause of cardiovascular morbidity and mortality. The discussion included information about newly available treatments and appropriate referral, geared for primary care and referring physicians, as well as advanced practitioners..

    In addition, in response to the opioid crisis in New York state and the urgent need for increased access to buprenorphine treatment for opioid overdose disorder, CDPHP helped promote a buprenorphine waiver eligibility training session presented by Daniel Cunningham, M.D. The lecture was geared to physicians, nurse practitioners, physician assistants, medical residents, RNs, LSWs, and pharmacists.