Hospitals Paying NonProfits to “Activate” Medicaid Patients

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Hospitals across the state, as part of the Medicaid reform initiative known as DSRIP (Delivery System Reform Incentive Program) are entering into agreements with local community based organizations to help them administer a tool called PAM (Patient Activation Measures) for Medicaid beneficiaries as well as uninsured and underinsured persons.   The state Department of Health has contracted with a company called Insignia and is requiring all health care systems participating in DSRIP to administer the ten question survey to hundreds of thousands of persons in the next few years, with initial goals to survey thousands by March 31, the end of the first DSRIP program year.

The PAM survey seeks to assess how “engaged” patients are in their own health care on a scale of 1 to 4 with 4 being most engaged.  A score is given by the program after responses are entered into a database.  The purpose of the survey is to get those with low engagement to improve.  For example, a person who scores a 1 and is determined to have little engagement in their own health will be coached to improve and take some concrete steps to improve any health conditions they have.  If the patient takes some of those steps they would be assessed higher the next time the survey is conducted.  The information will be shared with the patient’s primary care doctor or a clinic where they receive services.

Since completing the PAM surveys is a requirement of DSRIP, health systems are seeking help from many community services providers who interact with Medicaid beneficiaries and the uninsured.  The Albany Medical Center DSRIP project is paying nonprofits $36 for each survey completed.  The Alliance for Better Health Care which includes St. Peters Hospital in Albany and Ellis Hospital in Schenectady and St. Mary’s in Amsterdam is paying $25 per survey and an additional $50 for coaching the patient to improve their self management of their own health care.  Of course, the health systems are using their own staffs to conduct the survey for those who they interact with at hospitals and clinics.  However, the sheer number required for them to complete have led them to enlist as much help as they can from community services agencies which may not be directly involved in medical care.

Surveyors are given training on how to approach patients, administer the survey and then how to enter their answers into the software.  Some nonprofits have expressed concern and wonder how much on-going involvement is required for the payment provided.



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I have been a senior advocate for most of my career. I was Executive Director of the New York StateWide Senior Action Council and the New York State Alliance for Retired Americans. In 2007-2010 I was the Director of the New York State Office for the Aging

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