NYC PHIP Small Practice Project, Final Report

Prepared by United Hospital Fund in partnership with the New York City Population Health Improvement Program

Primary care practices in New York face pressure from payers and regulators to transition to a medical home model and to participate in value-based payment (VBP) contracts. The changes require increased operating costs in a way that is particularly onerous for small primary care practices, which are critical points of access for residents of some of New York City’s poorest neighborhoods. In many cases, the only option appears to be to join a much larger physician practice or a hospital-run physician practice.

A new report—which is a collaborative effort under the NYC Population Health Improvement Program (NYC PHIP), with funding from the New York State Department of Health—outlines a potential solution to the challenge that faces small primary care practices attempting to adjust to the new reality of VBPs.

A new, innovative model encourages sharing needed services across a group of small practices, enhancing their ability to serve as medical homes and succeed in VBP arrangements without exiting their small practices. In the new report, Manatt’s analysis of legal and regulatory issues finds that although VBP arrangements may be challenging, there are comparatively clear pathways to follow to work collaboratively and maintain these small practices. The report provides a framework for small practices considering joining a shared service model and for larger “host” organizations considering initiating shared service arrangements to benefit small practices.

Click here to read the full report.



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