It’s Not A Beer!
Jacob Reider, MD | Last updated: May 2020
When we announced that our IPA had executed our first contract, I found myself explaining what an IPA is and what it does. An IPA is a business entity that assists multiple independent organizations to contract with managed care organizations (health plans). We know that it’s uncommon (unheard of?) for an IPA to work with organizations that are not solely physicians but, as disruptive innovators, we are honored to curate an IPA – with you – that focuses explicitly on social determinants of health.
Where we are now
We have over seventy organizations participating in the IPA.
We have four executed agreements with health plans, and expect this to grow.
Where we are going (and why)
Our IPA is focused on helping organizations embrace (rather than fear) the change that is happening. These changes will, we hope, help us improve the health of hundreds of thousands of people in New York and beyond. Our plan is to continue to build relationships on both sides of this work: growing the breadth and scope of the organizations who join the IPA, while growing the number of health plans with whom we partner.
WHAT’S IN IT FOR YOU?
FIND OUT HOW WE CAN HELP YOU…
SOCIAL CARE ORGANIZATIONS
- Identify and pursue new and sustainable funding streams.
- Align your mission with those of managed care organizations.
- Access Healthy Together, our referral platform that makes it easy to track when, and for whom, services were provided to a community member while measuring the positive change.
- Prove cost savings to funders to demonstrate your value.
- Access our shared-infrastructure: technology, transportation, telephony, analytics, risk management, finance, compliance, privacy/security, HR, analytics, business/operations optimization, service line alignment, and referral management.
MANAGED CARE ORGANIZATIONS
- Supplement community investments.
- Meet NYS DOH requirements to enter contracts with organizations to address social determinants of health, without having to manage several partner relationships.
- “One stop shop” for securing, developing, and executing VBP contracts focused on social care initiatives with measurable ROI.
- Hold network participants accountable – working to meet quality measures through a unified technology platform that helps network members.
- Identify high-need individuals; track electronic referrals between clinicians and social care organizations; capture appropriate data to support quality measurement; report on service effectiveness and intervene where appropriate; and adhere to regulatory compliance standards and performance metrics.
- Achieve health plan/CMS/DOH savings through social care investments with demonstrated ROI to:
- Reduce medical expense/total cost of care
- Reduce administration burden/costs (churn)
- Increase revenue
- Improve Member satisfaction
- Improve regulatory compliance supports.
MEDICAL CARE + HEALTH SYSTEMS
- Attain shared savings through progressive contracting with managed care organizations.
- Manage referrals to the community rapidly and properly.
- Given this infrastructure, medical providers can:
- Enter risk sharing (level 2) agreements with managed care organizations
- Reduce “social admissions” that may not be reimbursed
- Reduce “social bed days” and delayed discharges due to social factors
- Reduce preventable readmissions within 30 days and subsequent CMS penalties
- Improve commercial and NYS/CMS clinical quality measure performance (and therefore revenue) – even with level 1 upside-only contracts