New York State Health Foundation

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Hudson River HealthCare

  • Project Title: Clinical Strategy Development for New York State Community Health Independent Practice Association
  • Priority Area: Special Projects Fund
  • Grant Amount: $173,343
  • Date Awarded: April 8, 2016
  • Region: Statewide
  • Region: Mid-Hudson
  • Website: https://www.hrhcare.org/
  • Grant Status: Complete

Overview

Federally qualified health centers (FQHCs) must develop and implement different strategies to remain economically sustainable and continue delivering care to medically underserved areas during health care’s shift from fee-for-service to value-based payment models. However, because of limited resources and influence, many FQHCs find themselves at a disadvantage, especially when it comes to negotiating terms with payers. Independent Practice Associations (IPAs) are networks formed by physicians that allow them to act as a private organization to contract and negotiate with insurers. In New York, an initial group of 10 FQHCs has formed the Community Health Independent Practice Association (CHIPA) as a way to increase members’ bargaining power and ensure financial sustainability. CHIPA was the first IPA formed among FQHCs in New York State and collectively provided care to more than 600,000 patients, many of whom were low-income and from vulnerable populations. In 2016, NYSHealth awarded Hudson River HealthCare, the fiscal sponsor to CHIPA, a grant to support CHIPA’s implementation and develop a clinical integration plan that would enable it to deliver value as a network, both regionally and statewide.

Under this grant, CHIPA was able to position itself as a critical network and collectively prepare for and enter into value-based payment contracts. Specifically, CHIPA assessed its members’ clinical integration needs and developed options and financial models for integration. After conducting the assessment and developing the model, CHIPA established an action plan to serve as the roadmap to achieve clinical and financial performance goals for members. Strengthening its network allowed CHIPA to better deliver comprehensive and high-quality care to its patients; enhanced its ability to secure better contracts with payers and other types of providers; and maximized new reimbursement models to improve members’ financial sustainability. CHIPA’s eventual goal was to sign on at least 25% of the 60 FQHCs in New York State as new members to increase statewide membership.