CDPHP Saves $20 Million in Health Care Costs

ALBANY, N.Y., Aug. 4, 2015 (GLOBE NEWSWIRE) -- CDPHP has announced the results of a study that show the health plan's Enhanced Primary Care (EPC) initiative produced an impressive $20.7 million in savings in 2014, all while improving the quality of care for hundreds of thousands of patients.

In 2008, after noting a decline in the number of local medical students who were choosing to become primary care physicians, CDPHP set out on a mission to save the field of primary care medicine. The result was the creation of the EPC program, a patient-centered medical home model that rewards doctors for spending more time with their sickest patients.

"EPC has given primary care doctors the freedom to practice medicine in a way that's innovative, efficient, and more convenient for their patients. This program puts patients at the center of the health care system, and encourages a team-based approach to care, allowing primary care physicians to work together with pharmacists, nurses, cases managers, and mental health experts to better coordinate the care of their patients," said Dr. John D. Bennett, president and CEO, CDPHP.

Value over Volume

A cornerstone of the EPC program is a unique payment model that rewards primary care physicians (PCPs) for their efforts to keep patients healthy. The program departs from the traditional fee-for-service model, which incentivizes doctors for providing more, not better care. Instead, EPC moves PCPs to value-based payments with the opportunity for enhanced bonus payments.

"We knew that in order for EPC to be successful, we needed to get doctors off the so-called 'hamster wheel' of fee-for-service. We are now rewarding doctors for quality over quantity, and offering significant bonus opportunities for those physicians who are able to meet specific performance metrics," said Dr. Bruce Nash, chief medical officer, CDPHP.

Now in its seventh year, the EPC program includes 193 physician practices, 836 network clinicians, and nearly 250,000 CDPHP members.

Dr. Holly Cleney is a primary care doctor at Latham Medical Group, part of Community Care Physicians, P.C. Her practice has been involved in the program since the get-go, and says EPC has allowed her and her colleagues to innovate in ways she never imagined.

"This unique payment model enhances, rather than discourages, our ability to be real primary care doctors, which means taking care of our patients both inside and outside the office. We're communicating electronically with our patients, offering group visits, and providing educational sessions on smoking cessation and diabetes management. We even have a patient advisory council that provides feedback on how we're doing!" said Cleney.

Bending the Cost Curve

In 2014, CDPHP realized a cost-savings of $20.7 million directly related to the EPC program. Approximately 60 percent of this savings was experienced by members within the commercial market, while approximately 20 percent was experienced by the sickest 10 percent of members in the Medicaid and Medicare markets.

EPC providers received an estimated $12.8 million more in reimbursements and enhanced bonuses than if they had not participated in the program. In exchange for these increased payments, CDPHP encouraged physicians to change the way they deliver care to patients. This often involves convenient office hours, communicating with patients via email, the use of patient portals and electronic medical records, and an overall emphasis on preventive care.

Improving Quality of Care

In addition to cost savings, the program has also produced impressive quality results. From 2010 to 2014, EPC sites showed significant improvements on a series of quality measures that included breast and colorectal cancer screenings, childhood immunizations, childhood well visits, and more. Throughout the analysis, quality scores for EPC sites rose from 71 to 77 percent. During the same time period, quality scores for non-EPC sites rose from 65 to 68 percent. The findings prove that EPC sites are not only performing at a higher level that non-EPC sites, but they are improving at a faster rate.

To read the full study and results, head to

About CDPHP®

Established in 1984, CDPHP is a physician-founded, member-focused and community-based not-for-profit health plan that offers high-quality affordable health insurance plans to members in 24 counties throughout New York. CDPHP is also on Facebook, Twitter, LinkedIn, Pinterest and Instagram.

CONTACT: Ali Skinner Director of Public Relations Capital District Physicians' Health Plan, Inc. (CDPHP) (518) 605-4497

Source:Capital District Physicians' Health Plan, Inc.