Media Contacts:
Valerie Foster, Harrison Edwards PR, 914-242-0010
vfoster@harrison-edwardspr.com
Ted Herman, Hudson Health Plan, 914-372-2204
therman@hudsonhealthplan.org

 

HUDSON HEALTH PLAN SCORES HIGHEST IN NYS DEPARTMENT OF HEALTH’S 2010 QUALITY INCENTIVE PROGRAM


For Second Year in a Row, Member Satisfaction, Quality of Service, and Compliance Measures Factor into Hudson’s Scoring Tops in NYS’s Annual Assessment of 18 Medicaid Managed Care Plans

FOR IMMEDIATE RELEASE
November 22, 2010

 (TARRYTOWN, NY) …Persistence and consistency are two qualities that Janet Sullivan, MD, Hudson Health Plan’s Chief Medical Officer, attributes to Hudson’s receiving the highest scores in the 2010 Quality Incentive Program, the annual grading of Medicaid managed care plans by the New York State Department of Health (DOH.) Hudson also placed first in 2009. The DOH’s Office of Health Insurance Programs annually assesses all 18 Medicaid managed care plans in the State. Hudson was the only plan to receive the highest level of incentive award, scoring a total of 114 out of 150 points. The plan with the next highest score received 87.2 points.

“Hudson’s goal is to deliver high quality, cost-effective care to the six New York Counties we serve,” notes Georganne Chapin, President and CEO of Hudson. “To receive the highest ranking two years in a row proves that the procedures we have set in place are helping us reach this important goal.”

She further notes that Hudson’s top ranking points to the dedication, professionalism and excellent care its health care providers give to every patient, and the hard work, commitment and enthusiasm every member of the staff demonstrates daily. “Hudson Health Plan is here for its members 24 hours a day, helping those who need it to get the medical care that everyone deserves,” Ms. Chapin says. “We also help our providers care for their patients through our Supporting Excellence Program.”

 Dr. Sullivan adds: “Our Supporting Excellence Program provides information and tools to help our primary care network deliver evidence-based care for our enrollees.”

Hudson’s Supporting Excellence Program began in 1999. “We began to analyze everything that we do to support our primary care network,” explains Dr. Sullivan. “We quickly figured out that to score well on quality measures, the doctors had to do something different. In addition to caring for the patient sitting in front of them, we asked them to begin thinking about the patients who were not coming in for check-ups or needed services. The goal was to consistently provide both primary care and preventative care.”

In 1999, Hudson reported how doctor’s fared on quality measures for the previous year. “We sent the report to the doctors, and were met with stony silence,” Dr. Sullivan says. “We knew no one looked at the report. The following year we thought, if we attached a check to the report, it would get a doctor’s attention. We calculated a bonus where the amount was based on how the doctor performed on these quality measures, and it worked.” The lesson isn’t that doctors do better if they’re paid more – the bonus was not a lot of money – but doctors, like everyone else, need to see tangible evidence that what they’re doing really makes a difference.

Since 1999, Hudson has added other Supporting Excellence programs for primary care around immunizations for children, managing diabetes, and counseling patients on the safe use of antibiotics.  The real key for these programs is that Hudson shares information with doctors about the services patients are missing. Hudson’s quality bonus program differs from the pay for performance (P4P) programs of other health plans because most Hudson bonuses are patient centered, paying on a “piece rate” – per patient – and not based on a practice’s hitting overall benchmarks. This approach encourages physicians to work with each patient to achieve the best possible care but does not penalize physicians if a few of their patients are not able to reach goals for blood pressure or sugar control.

The emphasis of the DOH’s annual assessment is on quality of care, focusing on nine benchmarks from a field of 40. This year’s benchmarks included asthma management, cholesterol controls, children’s dental, diabetes supervision and immunizations. “We never know which benchmarks the DOH will choose each year, which means that we need to be superior in everything we do,” Dr. Sullivan says.  “We regularly look at how we are doing in all forty quality measures. For the last two years, if we weren’t at the top of each measure, we were near the top. We are meticulous when calculating how we stand with each quality measure, and take steps to improve when needed.”

Dr. Sullivan says that working with the doctors often involves helping them optimize their administrative workflow and processes.

“For example, we work with offices regarding how to successfully submit a claim to accurately reflect the quality of care delivered to their patients,” Dr. Sullivan explains. “Sometimes people put in a wrong code, or fail to record a procedure that was done. Many doctors are providing great care; they’re just not recording the data correctly.”

A Perfect Score in Customer Satisfaction
In addition, Hudson achieved a perfect score in customer satisfaction, a direct result of the outreach programs Hudson has developed, including mailings and phone calls to members to remind them of specific care they need, such as diabetes check-ups or immunizations for their children. Dr. Sullivan cites an intense campaign Hudson initiated last year to be sure their members were getting mammograms. Hudson called every member in need of a mammogram, and in many cases, made the appointment for the member. Before the appointment, Hudson called the member as a reminder, and if the member did not make the appointment, another call was made and the process continued until the member had the mammogram. “This is just one of our many initiatives,” Dr. Sullivan says. “All of our initiatives work together to improve the overall health and well-being of our members, which in turn, contributes to member satisfaction with Hudson. We are not content to only do what is expected of us. We are always looking for new ways to go above the norm.”
 

About Hudson Health Plan

Founded in the mid-1980s by a coalition of community health centers, Hudson’s mission statement is "to promote and provide access to excellent health services for all people." The Tarrytown-based not-for-profit organization provides comprehensive medical and dental coverage to more than 100,000 members in New York’s Hudson Valley. Hudson has been driving health care innovation by developing technology to support clinical quality initiatives and to streamline the enrollment process for Medicaid Managed Care, Child Health Plus, and Family Health Plus. According to A Consumer’s Guide to Medicaid Managed Care in the Hudson Valley, it has earned the highest ratings in overall satisfaction among Medicaid Managed Care members in the Hudson Valley region every year since 2003.

Hudson Health Plan is the winner of the 2010 Platinum Award for Overall Case Management from the Case Management Society of America’s Case in Point Magazine; the Case Management Society of America 2007 Award for Excellence in Medication Adherence Management; the 2006 Poughkeepsie Journal Diversity in the Workplace Award; the 2005 Dr. Martin Luther King Jr. Corporate Award for Diversity from the YWCA of White Plains and Central Westchester; the 2005 Advancements in Health Care Award from Hudson Valley Life and Hudson Valley Parent; and the 2003 Community Leadership Award from The New York Health Plan Association. Visit Hudson on the Web at www.hudsonhealthplan.org.

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