CDPHP is putting the finishing touches on what it has nicknamed The Doctor’s Office Of The Future, a Route 9 facility that will bring together several medical practices and the insurer itself under a single roof.
“What we’re trying to do is begin to create an integrated [health care] delivery system for the Capital Region,” said Dr. John Bennett, president and CEO of CDPHP.
The goal is to create a seamless experience for the patient and a more efficient, more effective delivery of service by care provider and insurer alike.
It’s a joint effort of Albany ENT & Allergy Services, Albany Gastroenterology Consultants, Capital Cardiology Associates, Capital District Renal Physicians and CDPHP.
There isn’t a primary care practice on-site, but there will be telemedicine kiosks that can meet that need. And there are also two important neighbors — one of Community Care Physicians’ health parks is just across the street and an OrthoNY office is nearby.
This sort of on-site collaboration has been a longstanding goal of Bennett and CDPHP, which embedded employees at an office at Ellis Hospital in 2019 to assist members who are patients there. It later added a similar office at St. Peter’s Hospital and soon will open one at Albany Medical Center.
CDPHP also partnered with CDTA to create an on-site employee clinic at the transit agency’s Albany headquarters.
And it purchased Hometown Pharmacy in Watervliet last year, giving it a direct role in the delivery of medication — CDPHP will operate a pharmacy onsite at the new facility in Clifton Park.
All of these steps have the dual goal of improving the patient experience for the insurer’s members and improving their health outcomes, ideally while reducing costs and raising satisfaction ratings for the insurer in the process.
Bringing multiple healthcare providers together is new for CDPHP but not exactly new: Health care providers have been merging or affiliating for decades. Hospitals are just one example. If the proposed affiliation of Ellis Medicine and St. Peter’s Health Partners goes through, all ten hospitals in the eight-county Capital Region, home to 1.08 million people, will be part of either Albany Medical Center or SPHP. The two systems and Ellis have more than 30,000 employees combined, and also have scores of satellite facilities beyond their hospitals.
Physician groups have also merged and grown. Community Care Physicians now employs more than 2,000 people in 80 locations across the region.
But there’s a difference between bringing things together under a single corporate structure and tying them all together in a single integrated operating system, Bennett said.
Hospitals and large medical practices would likely counter that they are doing just that, working to improve community health and provide a continuum of care, he acknowledged.
“But they’ve not achieved the level of integration that’s necessary,” Bennett said.
This is what he wants to accomplish by bringing CDPHP further into the health care process.
He often says that CDPHP is not an insurance plan, it’s a health plan. Now, the goal is to be a healthcare payer/provider, or what the industry calls a payvider.
The payvider model is not new but in recent years it has become increasingly popular nationwide as a strategy for those that pay for health care and those that provide it to put aside their competing financial interests and collaborate to provide care at a lower cost.
Bennett cites Kaiser Permanente in California and Geisinger in Pennsylvania as models of comprehensive health care integration, and the two are often mentioned as successful examples of the payvider model, which doesn’t always work as well as hoped.
Kaiser has 12.4 million members, 23,000 physicians among 217,000 employees, 23,000 physicians and 39 hospitals. Geisinger has 540,000 members and 1,600 physicians among 24,000 employees; it runs nine hospitals, two research centers and one medical school.
CDPHP by contrast has 400,000 members and 1,100 employees. The huge differences in workforce totals exist because CDPHP does not operate dozens of medical facilities that care for members and nonmembers alike, as the other two do.
The new facility at 1785 Route 9 is CDPHP’s next step in that direction, and a larger step than its previous ventures. If the payvider initiative is shown to work here, it could be replicated elsewhere, Bennett said.
The facility, which still doesn’t have a name, will start hosting patients the first Monday in May. Those who make appointments will find a large and visually striking space with functional features and convenience amenities that include valet parking, the CDPHP pharmacy, electric vehicle charging stations, an onsite lab, refreshment center, a patient education center, a community room and telemedicine pods.
Bennett said success of the payvider model for CDPHP could mean changes for other organizations and perhaps resistance from those that are spending money and making efforts to create their own versions of an integrated care system. Competition is inevitable and continual in an industry that totaled an estimated $3.8 trillion in 2019, or 18% of the U.S. Gross Domestic Product.
But doubts can be overcome with results, Bennett said.
CDPHP overcame physician skepticism when it started its Enhanced Primary Care model more than a decade ago, with incentives to primary care physicians to demonstrate results through preventative care rather than simply diagnose and treat problems.
As it tests the payvider model, CDPHP will rely on its longstanding working relationships with the community benefit organizations whose mission is to improve population health and keep people out of the hospital, he said, and its relationships with the hospitals that provide care when they do become ill.
“I’ll work with anybody,” Bennett said.