Corporate Restructuring
In 2023, CDPHP initiated a corporate restructuring plan in response to mounting competitive forces, a rapidly changing health care environment, a shifting provider landscape, and an outdated, cumbersome governance structure. The changes initiated will preserve the company’s physician-directed care model, allow greater flexibility and access to capital, and advance its integrated model of health care delivery through key partnerships.
Strategic Alliances
CDPHP and Community Care Physicians
One such partnership has been an alliance between CDPHP and Community Care Physicians (CCP), one of the largest quality-driven medical practices in the CDPHP physician network. Together, the companies are establishing a shared headquarters at Wellness Way, an innovative, patient-centric medical home that will offer members and patients enhanced access to coordinated care and services.
Located in the heart of Latham, NY, the complex will house CCP primary care, specialty, and urgent care practices, CDPHP administrative offices, as well as laboratory and pharmaceutical services, all under one roof. Additionally, all CCP practices formerly located in the Capital Region Health Park in Latham will move to Wellness Way, as will CCP developmental pediatrics, rheumatology, and behavioral health specialty practices.
In addition to advancing the CDPHP integrated care delivery system, the move will also relieve administrative burdens and overhead for CCP medical practices while improving care quality and continuity, physician recruitment and retention, and the companies’ mutual capacity for growth.
Celebrating 10 Years of Enhanced Primary Care
Ten years ago, CDPHP launched its Enhanced Primary Care (EPC) program, an innovative care model designed to improve the quality and experience of care for patients, reduce burnout among physicians, and make care more affordable. EPC physicians receive enhanced payments ($35M annually) for delivering care that meets or exceeds quality benchmarks. Under this model, patient outcomes have improved, and the number of emergency room visits, length of hospital stays, and cost of prescription drugs (due to increased generic drug use) have decreased.
The program has expanded exponentially. As of 2023, there were more than 200 EPC sites, and 90 percent of CDPHP members with a primary care provider were receiving care from EPC providers. The program has also lowered costs significantly. A 10-year study of the program revealed a cost savings of nearly $400 million in health care costs.
These savings have not come at the cost of quality care. EPC providers have out-performed non-EPC practitioners in meeting key care quality metrics, including those established for asthma care, cancer screenings, and diabetes care, among others.
Also in 2023, CDPHP offered incentive payments to providers who encouraged their Medicare members to complete their annual wellness visits. This initiative generated savings of nearly $11 per member per month, yielded a 10 percent improvement in quality and patient satisfaction scores, and resulted in an annual wellness check engagement rate exceeding 50 percent.
Top Doctors Awards
The providers in the CDPHP network who strive to meet or exceed quality standards of care and earn high praise from their patients deserve recognition for their efforts. The CDPHP Top Doctors awards program, which is patterned after the principles guiding the company’s EPC program, does just that. The data compiled for the rankings each year also serve as a useful guide for its members as they make important decisions about who will oversee their care.
In addition to naming the top-performing pediatric, internal medicine, and family medicine providers and practices, the 2023 Top Doctor report also identified those practices and providers that excel in key categories, including cancer care, diabetes care, and overall patient satisfaction. Also honored were the first-ever Peabody Award winners, individual practitioners who were nominated by their patients, peers, and the public for delivering exceptional care.
Specialty Value-Based Payment Program
CDPHP has also invested in its network specialists by creating multiple specialty value-based programs. This initiative – built to accomplish the same goals as the CDPHP EPC value-based program – has given the company’s specialty care providers increased clinical, administrative, educational, and financial support.
Chronic Kidney Disease Management
CDPHP augmented its value-based program for renal specialists with network-wide promotion of its chronic kidney disease (CKD) management program. This innovative program affords patients with CKD access to care coordinated by a patient-centered team that includes renal specialists, pharmacists, dietitians, social workers, and behavioral health professionals. This higher level of comprehensive care helps delay, and can potentially eliminate, the need for dialysis.
A cornerstone of the program is access to same-day appointments for CDPHP members diagnosed with CKD. The program also incorporates early and ongoing education for members so that they are better-informed and more active participants in their care decisions.
CDPHP-QURE Enhanced Cardiac Care
The CDPHP cardiology specialty value-based program marked a milestone in 2023 with the successful completion of a two-year CDPHP clinical-simulation project. Presented in collaboration with QURE Healthcare of San Francisco, this educational project offered network cardiologists and advanced practitioners a highly engaging way to stay up to date with national cardiac care guidelines with the aim of reducing variations in clinical care and improving patient outcomes.
CDPHP claims data analysis has confirmed the success of the QURE project, with participating providers demonstrating marked improvements (compared with non-participating providers) in several key areas, including patient engagement with cardiac rehabilitation and significant pharmacy savings. Feedback from participating clinicians also underscored the value of the project, with 74 percent of cardiology providers saying they planned to change their approach to patient care in accordance with the latest standards.
A New Approach to Population Health Management
In 2023, CDPHP selected a new platform for population health management, Bridge, to help its providers better understand the health needs of the community, allocate resources effectively to serve those needs, monitor disease, and evaluate outcomes. Bridge’s real-time analytic tools will also help to ensure that practitioners are seeing patients at recommended frequencies in the right setting to facilitate early detection of disease.
The Bridge suite of apps includes advanced analytics, referral management, secure messaging, patient engagement, quality management, utilization/cost performance, and care management. These data will help inform CDPHP providers’ clinical decisions, promote continuity of care, and improve health outcomes.
Hospital to Home Program
A key component of the CDPHP integrated health care delivery model is its Hospital to Home program, now in its fifth year of operations. The inpatient care team keeps patients and their loved ones supported and well informed during and after a stay at participating hospitals and helps coordinate a seamless transition to recovery at home. Once a member is discharged from the hospital, outpatient care managers provide transitional care, assisting with setting up follow-up appointments, arranging transportation, offering encouragement, reconciling medications, ensuring access to nutritional meals, answering questions, and more.
In 2023, CDPHP continued its onsite and virtual presence at five local hospitals that account for 75 percent of its members’ inpatient care. The care team completed more than 15,000 face-to-face visits, with a 99.5 percent inpatient engagement rate and an 83 percent post-discharge engagement rate. Average member satisfaction was 86 percent across all lines of business.
One of the most important goals of the Hospital to Home program is to connect a patient with timely outpatient follow up, whether that be with their primary care provider or a specialist. This is a key factor in avoiding costly hospital readmissions. Eighty percent of adults discharged from medical care at the participating facilities experienced at least one follow-up visit within 30 days of discharge. On average, the first appointment took place four days post-discharge. As a result of the care team’s efforts, hospital readmission rates have continued to improve.
The CDPHP care management team also identified 932 members in need of nutritional support, resulting in delivery of more than 13,000 meals following hospital discharge. In addition, the care team connected 1,091 members with Papa Pals, a program that provides companionship, reminders, household help, and transportation. For a real-life, heart-warming example of the value and impact of the CDPHP Hospital to Home program, please visit the CDPHP blog.
1785 Specialty Medical Complex
May of 2023 marked two years since CDPHP opened the 1785 specialty medical practices building in Clifton Park with partners Albany ENT & Allergy Services, Albany Gastroenterology Consultants, Capital Cardiology Associates, and NY Nephrology. This medical facility is becoming widely known for its world-class patient experience, educational programs, and best-in-class medical care.
During the year, the number of patients receiving care at the building doubled, and aptihealth, a behavioral health practice, established their first brick-and- mortar location there. By the numbers, it was a banner year at 1785 for coordinated health care delivery:
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Cared for 60,000 patients
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Treated 4,000 walk-in patients at Capital Cardiology’s Enhanced Cardiac Access office
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Answered 1,100 questions about health insurance at CDPHP Customer ConnectSM
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Enrolled more than 100 new CDPHP members in a health plan
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Hosted 16 free community health events
Additionally, CDPHP hosted several community events at the 1785 building, including:
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Two blood drives in collaboration with the American Red Cross (60 donors).
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Eight themed pop-up events where community members learned about Medicare and received free health information.
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A community listening session co-hosted by CDPHP and the Alzheimer’s Association of NENY exploring barriers to care for families dealing with memory loss.
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A pop-up tabling event, co-sponsored with Albany Gastroenterology Consultants, which provided information about common diabetes-related symptoms affecting the digestive system.
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Three patient education seminars, held in collaboration with Capital Cardiology and Albany ENT & Allergy Services, that offered training or information on hands-only CPR training (25 attendees), surviving springtime allergies (232 attendees), and diabetes and diet (58 attendees).
White Glove Customer Service Training
CDPHP is not only committed to ensuring high-quality care for its members, it also strives to improve members’ experience of care and level of satisfaction with network providers. That is why the CDPHP enterprise training team developed a no-cost, “White Glove” customer service training program for administrators and employees of medical practices within the CDPHP provider network.
In 2023, 554 individuals attended these trainings either virtually (35 sessions) or in-person (24 sessions). Capital Care Physicians and NY Oncology & Hematology were among the practices that participated, investing in the professional growth and development of their staff.