WASHINGTON and NEW YORK, Nov. 6,
2018 /PRNewswire/ -- Evolent Health, Inc. (NYSE: EVH),
a company providing an integrated value-based care platform to the
nation's leading health systems and physician organizations, and
SOMOS IPA today announced that Evolent will support the SOMOS IPA
network in its operations as a Value-Based Payment (VBP) Innovator
in the New York State Department
of Health's Innovator program. As announced by the New York State Department of Health, SOMOS IPA
has received a new contracting designation as a Value-Based Payment
Innovator. The Innovator program is intended to encourage and
reward early adoption of Value-Based Payment arrangements,
supporting groups who have invested in moving toward population
health management. With its Innovator designation, SOMOS aims to
transform the communities it serves by reintroducing the family
doctor and strengthening the bond between doctor and patient.
SOMOS IPA is the only physician group with Innovator designation
to date, mirroring its status as the only physician-led,
community-based participant in the New
York State Department of Health's Delivery System Reform
Incentive Payment (DSRIP) program, which was established to help
improve outcomes and reduce avoidable hospital use by 25 percent.
Through the Innovator program, SOMOS and Evolent aim to serve
Medicaid beneficiaries in New York
City through a doctors-first, culturally-sensitive care
model with a particular emphasis on social determinants of health.
In collaboration with SOMOS providers, Evolent will deploy clinical
programs to proactively address health issues to improve outcomes
and avoid unnecessary hospital use. Evolent is also providing SOMOS
with its population health performance management platform,
IdentifiSM, to share critical analytics across network
providers, facilitate efficient care coordination, launch and
operate a suite of clinical programs and integrate clinical and
other data across the network.
SOMOS IPA is focused on strengthening connections between
doctors and patients in some of the highest need and most diverse
communities in New York. Founded
by Dr. Ramon Tallaj, an immigrant himself and longtime leader in
the Latino community, SOMOS IPA is comprised of three
community-based Physician IPAs—Corinthian, Excelsior and Eastern
Chinese American Physicians—as well as a range of other
community-based organizations.
"Our priority is to create the best connection possible between
people and providers. 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—and it's only
through our network's partnership with Evolent that we can meet
this challenge and save lives," said SOMOS IPA Founder and Board
Chairman Dr. Ramon Tallaj.
"Traditionally, large health organizations have been the only ones
with the infrastructure to take on fully-capitated risk. The
State's recognition of our ability to accept full risk, including
health plan functions, is ground-breaking. We look forward to
leveraging the strength of our network and Evolent's capabilities
to spearhead a physician-led care model and continue to build a
sustainable, transformative connection with patients."
According to the New York State
Department of Health, New York's
Value-Based 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. SOMOS and Evolent will work together to connect
patients to local community resources to support patients outside
of the doctor's office.
Value-Based Payment Innovators can contract at the most advanced
payment levels with Managed Care Organizations (MCOs) to improve
quality of care for a defined group of patients while sharing in
financial gains and risks. As a participant in the Innovator
program, SOMOS IPA is now able to pursue delegated risk
arrangements with MCOs in which it would take on additional
management and administrative functions, such as utilization and
claims management. SOMOS IPA would then be eligible for an
increased portion of the monthly payment made by Medicaid for the
lives it manages in the program. Over the coming months, SOMOS
intends to contract with MCOs to take on delegated risk and begin
care coordination for Medicaid lives in mid to late 2019.
"We are honored to work with SOMOS to put primary care at the
forefront of the value-based care delivery system to address the
unique challenges of its Medicaid population," said Evolent Health
President Seth Blackley. "When
Evolent and SOMOS considered the opportunity presented by the
Innovator program, we were aligned in our mission to bring our
capabilities together to empower physicians to manage
fully-capitated risk—a model we are confident will help shape the
future of health care in New York.
Evolent is proud to bring the full set of financial, administrative
and technology capabilities SOMOS will need to succeed at managing
full risk for its New York City
communities."
"We applaud SOMOS IPA for achieving Value-Based Payment
Innovator status and continuing to move the needle on value-based
care in New York," said Evolent
Health Chief Executive Officer Frank
Williams. "With deep ties to its New York City communities and a reputation as
a leading provider network, SOMOS is well-positioned to be a
national model for culturally-sensitive preventive and primary
care, and for structuring a community-connecting care organization
to be financially stable under Medicaid."
As announced in May 2018, Evolent
and SOMOS IPA originally partnered to support the performance goals
of New York's DSRIP program. For
more information, please refer to Evolent's press release.
About Evolent Health
Evolent Health partners with
leading provider organizations to achieve superior clinical and
financial results in value-based care and under full-risk
arrangements. With a provider heritage and over 20 years of health
plan administration experience, Evolent operates in more than 30
U.S. health care markets, actively managing care across Medicare,
Medicaid, commercial and self-funded adult and pediatric
populations. With the experience to drive change, Evolent
confidently stands by a commitment to achieve results. For more
information, visit www.evolenthealth.com.
About SOMOS IPA
SOMOS Independent Practice
Association (IPA) is the only physician-led group to be
designated as a Value-Based Payment Innovator by the State of New York. SOMOS IPA is a network
of three community-based Physician IPAs—Corinthian, Excelsior
and Eastern Chinese American Physicians—that also includes 17
community-based organizations that help address social determinants
of health by contracting with seven Medicaid Managed Care
Organizations. SOMOS IPA anticipates caring for an
estimated 180,000 Medicaid members in its first
year. SOMOS IPA is supported by a partnership with
Evolent Health, which provides clinical programs and a population
health performance management
platform. SOMOS IPA will transform the diverse
communities it serves by strengthening the connection between
families, doctors and patients in neighborhoods throughout the
Bronx, Brooklyn, Manhattan and Queens with culturally competent care.
Contacts:
Bob East
443.213.0502
Investor
Relations
InvestorRelations@evolenthealth.com
|
Kim
Conquest
540.435.2095
Evolent Media
Relations
KConquest@evolenthealth.com
|
Jon
Reinish
202.999.0461
SOMOS Media
Relations
JReinish@skdknick.com
|
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SOURCE Evolent Health