Transformation in health care delivery must solve a value equation: Improve the quality of care for both the patient and the community at large, while increasing cost effectiveness. Developing strategies that are most effective to accomplish both quality improvement and lower costs, and then operationalizing those strategies, is a challenge being tested in projects across the nation. The Hudson Valley presents a unique test bed for this research as an open community, rather than an integrated health system.

Two current research projects are taking a close look at both quality and cost. The first is a longitudinal study tracking 26 quality and utilization measures of cost and quality, examining the use of electronic health records in practices that are NCQA-recognized Level 3 medical homes. This study began with baseline data from practices prior to their medical home transformation, and continues to evaluate data over a four-year period. The project is supported with a HEAL grant from the New York Department of Health and is managed in collaboration with the Taconic Health Information Network and Community (THINC). Capabilities demonstrated in this area include project management; ongoing intelligence gathering on practice and provider demographics including EHR status; development of a database to store data collection results; implementation of the medical home and care coordination interventions; and central coordination with collaborators.

The second quality and cost project evaluates the use of care coordination in the medical home setting, examining the same 26 quality and utilization measures at baseline and over three sequential years. The project is also supported with a HEAL grant from the New York Department of Health and managed in collaboration with THINC.