The Value-based Payment plan is a new way to pay doctors. Currently, the sicker the person is, the more the doctor gets paid. On top of that, it does not matter what the quality of the work of the doctor is. In Value-based Payment, the incentives are reversed, so that the more the doctor is able to keep the patient healthy through keeping them out of the hospital in the emergency room, and by doing preventive quality care, the more the Physician will be paid. GBUACO is in one of the first New York State Value-based Pilot programs in partnership with the Medicaid MCO YourCare. As part of this, 15 quality metrics were agreed upon to help improve care. How much the ACO kept of whatever shared savings it produced was dependent on how many quality metrics that were met.

Performance Results
*Data are illustrative only and intended to only generally measure performance.

Agreed-Upon Quality Metrics

Antidepressant Medication Management - Acute
Asthma Medication Ratio - Age 5 - 18
Asthma Medication Ratio - Age 19 - 64
Adolescent Well Care Visits
Breast Cancer Screening
Controlling High Blood Pressure
Comprehensive Diabetes Care - HbA1C Test
Comprehensive Diabetes Care - Eye Exams
Comprehensive Diabetes Care - Nephropathy
Comprehensive Diabetes Care - Blood Pressure Control < 140/90
Comprehensive Diabetes Care - Good HbA1C Control < 8.0
Chlamydia Screening - Age 16 - 24
Colorectal Cancer Screening
Statin Therapy for Patients with Cardiovascular Disease - Statin Adherence 80%

Well Child Visit in the 3rd 4th 5th and 6th Years of Life

Results

The IPA met the most metrics 13 out of 15
Urban Family Practice was the leader in accomplishing this.

Group Measures Met

  • GBUIPA | 13
  • JERICHO | 10
  • KALEIDA | 8
  • ECMC | 7
  • WNY MED | 3

This was lead by Urban Family Medicine. Urban Family Medicine did better than the IPA, which did better than the ACO as a whole, and they all did better than YourCare as a plan.

Performance Results
*Data are illustrative only and intended to only generally measure performance.

Colorectal Cancer Screening
Statin Therapy for Patients with Cardiovascular Disease - Statin Adherence 80%

Overall, Urban Family Medicine did better than YourCare as a plan in 12 of the 15 metrics, they did the same on two of the 15 metrics, and worse on one.

In Quality

The ACO Outperformed both State and National Averages

  • The ACO did better than the Nation in all 12 measurable Metrics
  • The ACO did better than the State in 9 of 15 Metrics