July 01, 2014 News

From Volume to Value

A quiet revolution is taking place in the health care field, and it has the potential to improve both the quality and affordability of care in this country and here in the Capital Region.

Value-based care is a system that pays doctors based on the quality of services provided to patients. Currently, our health care system operates through a fee-for-service system, which means that doctors are rewarded based on the number of patients they see. Research shows that fee-for-service often means more tests and higher costs and not necessarily better care.

These challenges prompted some health insurers to develop new models of care called patient-centered medical homes (PCMHs), which emphasize quality over quantity.

In 2008, CDPHP implemented its own PCMH called the Enhanced Primary Care (EPC) initiative. The program abandoned the “fee-for-service” model, which has historically reduced the amount of time doctors are able to spend with patients. Instead, EPC rewards doctors for spending more time with patients with the greatest needs.

Early results have shown an increase in patient and physician satisfaction, a reduction in ER visits, as well as improved clinical quality scores. Furthermore, upfront investments in these initiatives are often recouped due to fewer ER and urgent care visits.

More About the CDPHP EPC Program

Our EPC practices are designed to treat the whole patient and improve their experience of care. This is accomplished through electronic health records, convenient appointments, and access to the right medical professionals at the right time. You can find an EPC location near you by using our Find-A-Doc search tool. EPC providers are indicated by a green “home” symbol.

The goal of the EPC program is to put more focus on disease prevention and chronic care coordination. Since it was first implemented in 2008, the program has grown to include 200 practices and about 900 clinicians.

The following results have been noted:

  • More than 200,000 CDPHP members visit an EPC practice
  • 15 percent reduction in inpatient admissions
  • 9 percent reduction in emergency room visits

The Capital Region is home to a wealth of health care, university, and financial institutions. Thus, I believe that we can work together to move toward a pay-for-value system that will benefit providers, employers, and patients and ultimately improve health care while reducing costs.

John D. Bennett, MD, FACC, FACP
About the Author

John D. Bennett, MD, FACC, FACP, is president and CEO of Capital District Physicians’ Health Plan, Inc. (CDPHP), an award-winning, physician aligned, not-for-profit health plan based in Albany, NY. Bennett has held the position since 2008 after serving more than 10 years as chair, vice chair, and board member for CDPHP. During his tenure, CDPHP has been ranked among the top-performing health plans in New York and the nation, most recently named #1 in Customer Satisfaction in the 2023 J.D. Power Member Health Plan Study. Under his leadership, CDPHP has also become known as a model employer regionally and nationally and was recently named among the top five Best Companies to Work for in New York by the Society for Human Resource Management, as well as Forbes Best-in-State Employers 2022. Prior to joining CDPHP, Bennett served as founding member and CEO of Prime Care Physicians, PLLC. During his tenure, he co-led a team of 25 cardiologists and helped grow the practice to a 100-physician multi-specialty group. Bennett is board certified by the National Board of Medical Examiners and the American Board of Internal Medicine, with subspecialties in internal medicine and cardiology. He earned his medical degree at SUNY-Downstate Medical Center, Brooklyn, and a Bachelor of Science degree at Rensselaer Polytechnic Institute. Bennett completed an internship and residency in internal medicine and a fellowship in cardiovascular disease at Albany Medical Center. He is a Fellow of the American College of Cardiology and the American College of Physicians. Bennett is currently board chair for the Center for Economic Growth and the Capital Region Chamber, and vice chair for the Palace Theatre. Bennett also serves on the boards of the New York eHealth Collaborative (NYeC), the Alliance of Community Health Plans (ACHP), America’s Health Insurance Plans (AHIP), Rensselaer Polytechnic Institute, and Russell Sage Colleges. Bennett is a member of the New York Public Health and Health Planning Council where he helps shape decisions related to New York State's public health and health care delivery system. Well-known locally and nationally for advancing health care innovation, Bennett was recently named to Crain’s New York Business 2021 Notable in Health Care, as well as the Albany Business Review’s Power 50 list.

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