ROCHESTER, N.Y. (06/15/2012)(readMedia)-- The federal Center for Medicare & Medicaid Innovation (CMMI) has awarded a $26.6 million, three-year grant to the Greater Rochester community to transform health care in the Finger Lakes region by providing a more comprehensive primary-care model to patients most at risk for hospitalizations and emergency-room visits.
The Rochester Health Innovation Collaborative (RHIC), a community coalition project of Finger Lakes Health Systems Agency (FLHSA) chaired by New York State Assemblyman Joseph D. Morelle (D-Irondequoit) guided the grant application process. This group included 30 leaders representing area hospitals, employers, health plans, physicians, nurses, philanthropic foundations, community advocacy groups, higher education and government.
FLHSA will administer the Health Care Innovation Grant on behalf of the community. Specifically, this project - "Transforming Primary Care Delivery: A Community Partnership" - will help strengthen primary care and provide care coordination to the more than 658,000 Medicare and Medicaid patients at risk for potentially avoidable hospitalizations, hospital readmissions and avoidable emergency department use. This effort is expected to reduce health care costs by $48 million over the next three years by improving people's health, reducing the need for the most costly services.
Ultimately, the project's aim is to improve the community's health and health care delivery while lowering the cost of care through a three-pronged approach:
Primary care physicians will receive technical support and work with a team of care managers, care coordinators, and community health workers. FLHSA will train 726 health workers and provide funding for 76 care managers, community health workers and community-based care coordinators in physician practices in the six counties of Monroe, Livingston, Ontario, Seneca, Wayne and Yates.
FLHSA Executive Director Fran Weisberg said, "These grant funds are a game-changer, as our community will fundamentally change the way health care is provided through new tools to deliver better health, to improve care and to lower costs by reducing unnecessary utilization. Our community is being awarded this grant because health care collaboration is in our DNA, because our region is at the forefront of health care reform – as evidenced by our innovative and collaborative efforts to create a high-performing health system – and because the entire community came together for a common goal."
This broader effort will expand on a successful patient-centered medical home pilot program funded by Excellus BlueCross BlueShield and MVP Health Care.
"Today's investment will help marshal the enormous brain power in Rochester toward solving the problem of escalating health care costs nationwide, all the while boosting patient care and creating good-paying health care jobs in the region. That is why I fought for Rochester to receive what is one of the largest grant awards in the nation made by the federal government today," said U.S. Senator Charles E. Schumer (D-NY) who wrote to Health and Human Services Secretary Sebelius urging HHS to approve the grant application, and met personally with Centers for Medicare and Medicaid Services (CMS) Administrator Marilyn Tavenner to advocate for the Rochester coalition.
"Rochester is already a high quality, lower cost community for health care," said David H. Klein, chief executive officer for Excellus BlueCross BlueShield. "What's unique about this new project is the promise for further improvements in quality and cost management. Patients who have been involved in the medical home project have dramatically improved their health in the first two years of the program. Data shows that patients are better managing chronic conditions such as diabetes and cardio-vascular disease, and more patients are getting cancer screenings. This grant will help to extend that success throughout the community."
Klein noted that Rochester, N.Y. is in the lowest nine percent for risk-adjusted Medicare spending nationwide. Medicare spending in Rochester is 21 percent below the national average and commercial insurance costs are 30 percent below the national.
"Thanks to the leadership of Finger Lakes Health Systems Agency and its community partners, this innovative collaboration will improve the health and healthcare for thousands of people with chronic illness throughout the Greater Rochester area, while also reducing the cost of care," said New York State Health Commissioner Nirav R. Shah, M.D., M.P.H.
"Rochester has a long history of leading the way in health care reform, both at the state and national levels," said New York State Assemblyman Joseph D. Morelle (D-Irondequoit). "We are delighted that Washington is once again recognizing Rochester's leadership in improving health system performance and in controlling health care costs."
"Due to our unprecedented level of community collaboration which includes all health care stakeholders, which is better than anywhere else in America, and with our transformational vision, together we convinced the federal government that our grant application should be approved which will significantly help our community move much closer to meeting our goal of being the healthiest community in America," said Paul S. Speranza Jr., Wegmans Food Markets Vice Chair, General Counsel and Secretary.
"This award is a great demonstration of how Rochester is a leader and a model of effective collaboration," said Leonard E. Redon, Rochester's Deputy Mayor and chair of the commission. This high level of leadership and teamwork will be critical as the real work of the grant begins."
CMMI, part of the Centers Medicare & Medicaid Services (CMS), announced in 2011 that it would award up to $1 billion in its Health Care Innovation grants for "compelling new ideas to deliver better health, improved care and lower costs to people enrolled in Medicare and Medicaid, particularly those with the highest health care needs."
About FLHSA - Finger Lakes Health Systems Agency (www.flhsa.org) is an independent, regional health planning organization working to improve health care in Rochester and the Finger Lakes region. The agency analyzes community needs, brings together organizations to solve health problems, and measures results. FLHSA serves the nine counties of Chemung, Livingston, Monroe, Ontario, Schuyler, Seneca, Steuben, Wayne and Yates.
Excellus BlueCross BlueShield, a nonprofit independent licensee of the BlueCross BlueShield Association, is part of a family of companies that finances and delivers vital health care services to 1.8 million people across upstate New York. Excellus BlueCross BlueShield provides access to high-quality, affordable health coverage, including valuable health-related resources that our members use every day, such as cost-saving prescription drug discounts and wellness tracking tools in our Step Up program. To learn more, visit https://www.excellusbcbs.com.