New York Medicaid Providers Reach New Value Based Payment Contracting Designation

NYU Langone and Montefiore Approved as Innovators

Networks Will Serve an Estimated182,000 Medicaid Members

ALBANY, N.Y. (July 17, 2018) - The New York State Department of Health (DOH) today announced that NYU Langone Independent Practice Association (IPA) has been designated as an Innovator under Medicaid's Value Based Payment (VBP) Roadmap, a key component to the Delivery System Reform Incentive Payment Program (DSRIP). NYU Langone IPA is the second organization to be designated as an Innovator by the Department joining Montefiore (MACO-IPA) which was designated earlier this year.

Innovators contract at the most advanced payment levels with managed care organizations to improve quality of care for a defined group of patients while sharing in financial gains and risks. By taking on additional management and administrative functions, providers approved as Innovators are eligible for an increased portion of the monthly payment made by Medicaid to the Managed Care Plan. New York's Roadmap is unique in requiring Innovators to include community-based organizations and address social determinants of health interventions such as housing, food insecurity or transportation. Social determinants of health are recognized as having a significant impact on the health and well-being for Medicaid members. As part of New York's $8 billion DSRIP federal waiver, which was secured by Governor Cuomo in 2014, the VBP Roadmap builds on the success of DSRIP's Performing Provider Systems (PPS) and paves the way for New York's Medicaid program to shift to paying for value over volume.

"I congratulate NYU Langone on their designation as a Value Based Payment Innovator," said New York State Health Commissioner Dr. Howard Zucker. "As the health care landscape continues to change, it is important that providers across the state challenge themselves to best meet the needs of their communities and that is precisely what we are seeing with these Innovator designations."

The NYU Langone Innovator network will include the facilities of NYU Langone Health including Tisch Hospital, Rusk Rehabilitation, NYU Langone Orthopedic Hospital, NYU Langone Hospital—Brooklyn and the newly opened Hassenfeld Children's Hospital at NYU Langone. The network also includes over3,500 health care providers including 2,300 physicians representing more than30 specialties including primary care, pediatrics and OB/GYN; more than 650 nurse practitioners and physician assistants; and nearly 300 behavioral health, dental, audiology, physical and occupational therapists, optometry and nutrition providers. The Innovator network will also work withcommunity-based organizations to help address social determinants of health such as housing and nutrition. TheNYU Langone Innovator network estimates it will care for67,000 Medicaid members primarily in Brooklyn in its first year.

NY State Medicaid Director, Donna Frescatore said, "We congratulate these organizations for being designated as Innovators and for sustaining the progress they have made as Performing Provider Systems under the DSRIP waiver. Innovators represent an unprecedented level of community collaboration to improve the health of Medicaid members at the local level."

Senior Vice President and Vice Dean for Clinical Affairs and Strategy and Chief Clinical Officer for NYU Langone Health, Dr. Andrew Brotman said, "We are excited to take this next step on the road to value based care. We hope that Innovator status will allow us to continue our goal of improving the care and quality outcomes of our patients."

In February of this year, DOH designated Montefiore ACO-IPA as an Innovator under the terms of the Roadmap. MACO-IPA is a network comprising 11 hospitals including a children's hospital and a rehabilitation hospital, as well as mental health and substance abuse clinics, dental clinics, imaging centers, surgical and specialty centers and a free-standing emergency room. Community-based organizations collaborate to address social determinants of health including neighborhood, environment and food insecurity. An estimated 115,000 Medicaid patients will receive care through this network.

For more information about New York's Value Based Payment Roadmap and the Innovator Program, visit:

For more information about DSRIP, visit: