New Jersey AFP Prepares to Roll Out Practice Transformation Project

A group of primary care physicians in New Jersey soon will begin the process of transforming their practices into patient-centered medical homes, or PCMHs, by participating in a joint pilot project launched by the New Jersey AFP and Horizon Blue Cross Blue Shield of New Jersey, the state's largest insurance carrier.

The project will involve 25 to 50 primary care practices. The practices will take part in a three-month course that will walk them through elements of the PCMH to help them achieve recognition as a level one or level two medical home according to the National Committee for Quality Assurance, or NCQA, medical home recognition program.

"This project is designed to take a first step toward assisting physicians who wish to begin the process of transformation and to do so with the kind of assistance that they have been telling us over time that they need," said New Jersey AFP EVP Ray Saputelli, C.A.E., in an interview with AAFP News Now.

The New Jersey AFP designed the project and is rolling out the initiative through a grant from Horizon. State chapter officials will choose practices for the program using a blinded application process open to every primary care physician practice in the state, not just New Jersey AFP members, said Saputelli.

In early spring, the chapter will hold a project launch meeting for the practices selected to participate, laying out their roles and responsibilities and providing them information about how to qualify as an NCQA-recognized PCMH.

Saputelli said the New Jersey AFP will hand out coursework during the three-month period, assigning coaches to work with the practices and help them through the NCQA recognition process.

"Each week will focus on one of the elements of the (NCQA) application," he said.

Participating practices are required to use an electronic health record, or EHR, system or an electronic patient registry to manage patient care and track outcomes. For participating practices that do not have either of these technologies, the project will provide electronic registry technology.

"The registry will allow physicians to track patient care across the continuum of the multidisciplinary team and also to automate some of the care coordination processes," said Saputelli.

Horizon, meanwhile, will pay physician practices in the program a per-member, per-month care coordination fee for managing the care of patients with diabetes.

Horizon has provided money for one year, but Saputelli expects the project to continue beyond that timeframe and to eventually include other insurance carriers and payments for managing other chronic diseases.

"If we can get one payer to come to the table and participate in this type of project, we can get other payers and partners to follow," said Saputelli.

Within the next year, participating practices should have made "real strides" in the transformation process, leading to improvements in how they deliver and manage patient care for patients with diabetes, he said.

"We are trying to build something that we can hold up to physicians and say, 'Here are some physicians who have started the process of transforming their practices -- we were able to give them help and provide them with infrastructure, as well as some additional compensation,'" said Saputelli.