Physician Group Reaches New Value Based Payment Contracting Designation

SOMOS-IPA Approved as an Innovator

First Physician Group to Achieve Innovator Designation

ALBANY, N.Y. (August 14, 2018) -- The New York State Department of Health today announced that Somos Independent Practice Association has been designated as an Innovator under Medicaid's Value Based Payment (VBP) Roadmap, a key component to the Delivery System Reform Incentive Payment (DSRIP) Program. Somos-IPA is the first physician-led group in the State to reach VBP Innovator status.

VBP 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. 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.

"Congratulations to Somos IPA on their designation as a Value Based Payment Innovator," said New York State Health Commissioner Dr. Howard Zucker. "As Performing Provider Systems continue to achieve Innovator designations and streamline the way in which they deliver care, we are building a stronger, more effective health care delivery system in New York."

The Somos-IPA, which is comprised of three community based Physician IPAs, Corinthian, Excelsior, and Eastern Chinese American Physicians, will cover Bronx, Kings, Queens, and New York Counties. The Innovator network will also partner with Montefiore Health System & St. Barnabas Hospital, MEDISYS Health System, NYU Health System, and Wycoff Heights Hospital. Included in the Somos-IPA Innovator network will be seventeencommunity-based organizations to help address social determinants of health such as nutrition, economic stability, and housing. By contracting with seven Medicaid Managed Care Organizations, the SOMOS-IPA will care foran estimated 180,000 Medicaid members in its first year.

NY State Medicaid Director, Donna Frescatore said, "Somos-IPA's partners and affiliates have a history of successfully contracting in Value Based Payment arrangements. Their dedication to improving the lives of the Medicaid members they serve, will have a lasting impact on the health and wellbeing of their local communities."

"The best connection possible between people and providers is our priority, and the state's investment in our work gives every doctor in the SOMOS network the tools to address persistent health disparities in diverse, vulnerable communities," said Dr. Ramon Tallaj, MD, Chairman of the Board of SOMOS Community Care. "As the only physician-led health care network that participates in Governor Cuomo's DSRIP initiative, we are committed to ensuring the program's mission continues. Being designated as a Value Based Payment Innovator will help SOMOS continue to aggressively pursue innovative methods to address persistent health challenges experienced by the most vulnerable and, until now, underserved populations. We place tremendous value on leading from within the communities we serve to provide patient-centered and culturally-competent care. Our network is different, and we are grateful that the Governor and the Department of Health see difference as an asset and a strength. We look forward to working with the state to transform health care by reintroducing the family doctor back into neighborhoods, boosting quality, driving down costs patient-by-patient, and saving lives in the communities that need it most."

Somos IPA is the third VBP Innovator designated by the State. Earlier this year, DOH designated Montefiore ACO-IPA and NYU-Langone IPA, two hospital-led systems, as VBP Innovators.

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

For more information about DSRIP, visit: