Performing provider systems are partnerships of regional care providers who collaborate to ease the transition from fee-for-service payment to a pay-for-performance approach.
The goal of the call-back program is to identify emergency room “super utilizers” who are either on Medicaid or enrolled in a Medicaid HMO and pair them with primary care providers or medical homes to reduce future avoidable visits.
“Believe it or not, we have patients who are in such dire need of coordinated health care. They’ve been in the ER literally a dozen times in a month and that’s just not right for anybody,” said Scott Kitchen, vice president of clinical and business intelligence at the PPS, according to the report. “We’ve really worked to try to find a way to help these patients and … provide them the care they need in the appropriate setting that’s very connected.”
There are 25 PPS in New York that match up physicians, hospitals and community-based organizations to implement the state’s Delivery System Reform Incentive Payment program. Along with other PPS, Community Partners of WNY are selecting from numerous public health projects to further the state’s $8 billion DSRIP program, which is tasked with reducing avoidable hospitalizations by 25 percent by 2020, according to the report.
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