Collaboration moves metrics

CDPHP_3405_rgbWe definitely have a place in the community,” says Capital District Physicians’ Health Plan, Inc. (CDPHP) Vice President of Health Care Quality Renee Golderman. “We give to the community, we work with the community, we really believe it’s where health care begins.”

If CDPHP’s focus is local, its reputation is increasingly national. CDPHP’s quality rankings improved in all three lines of business this year in the National Committee for Quality Assurance (NCQA) Health Insurance Plan Rankings. The Albany, N.Y., organization’s Medicaid and Medicare plans each ranked ninth and its commercial line ranking advanced from twenty-eighth to eighteenth.

The improvement in NCQA rankings captures CDPHP’s continuous commitment to personalized care. CDPHP prides itself on developing new approaches to care that prioritize members’ convenience. Insurance cards can be downloaded to one’s mobile device, for example, and a program called Text for Baby sends reminders and tips to expectant mothers throughout their pregnancy and after the child is born. CDPHP’s benefit design includes hundreds of free wellness classes per year, the Life Points incentive program, as well as other tools and resources to help members reach their personal health and fitness goals. “We try to find the right channels for every member,” Golderman says.

In terms of delivery, CDPHP is particularly proud of its patient-centered medical home model, the Enhanced Primary Care (EPC) initiative, which has grown since 2008 to cover half of all CDPHP members. EPC is a partnership with physicians: CDPHP supports providers in the simultaneous transitions to payment reform and practice transformation by offering action plans, tools and technology and practical data. EPC has helped CDPHP improve the quality of care for 15 of 18 specific HEDIS® measures and has reduced hospital readmissions by 15 percent.

“The real benefit is the sense of collaboration we have with our physician community,” Golderman says. “Collaboration directly moves our metrics.

-Sophie Schwadron 
ACHP Intern