Before DOH enforces its benchmarks, this quick action checklist shows you exactly what to confirm now.
Don't waste precious time
Download the action checklist that positions your facility to secure and sustain enhanced Medicaid per member per month (PMPM) payment under the Medicaid 1115 waiver.
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A trusted NCQA liaison that works with physician practices, hospitals, insurance vendors and healthcare organizations nationwide.
PCMH recognition alone is no longer enough
While Patient-Centered Medical Home (PCMH)-recognized practices in New York are eligible for enhanced Medicaid PMPM under the 1115 waiver, continued access will depend on readiness, reporting accuracy and performance alignment. Inside, you’ll find the critical areas your site must prepare for now.
PCMH and attestation readiness
Revenue eligibility validation
eCQM reporting preparation
Performance improvement and risk mitigation
DOH benchmarks will determine continued access to enhanced payments. Sites that wait to act may face avoidable reimbursement risk once benchmarks are enforced.
Mandi Diamond, PCMH CCE
Senior practice transformation advisor, DataGen
Get the full enhanced PMPM guide
Access expert strategies that teach PCMH practices how to protect revenue, meet new requirements and prepare for performance-based accountability under New York's 1115 waiver.
Clear eligibility and immediate action steps A straightforward breakdown of eligibility requirements and actions your practice must take now to protect and secure enhanced PMPM.
How the 1115 waiver is shifting accountability
Explanation on New York state’s broader move toward value-based accountability.
Financial risk, eCQM readiness and performance strategy
Insight into the operational and revenue risks ahead, why electronic clinical quality measure (eCQM) readiness is now a strategic capability and how to prepare for performance benchmarks.
Action checklist and practical roadmap
A step-by-step path from eligibility to sustainability, including a tactical action checklist and how DataGen can support execution.
