Yuvo Health, a managed and managed care solution for community health centers, has entered into a new partnership with Centene subsidiary Fidelis Care to bring value-based care to New York’s federally qualified health centers and their Medicaid populations middle.
Value-based care is a system that incentivizes providers and insurers to reduce the cost of care and improve the quality of care by sharing savings between the two entities. The Yuvo Health CEO said large health systems have a disproportionate advantage in value-based care because they have the larger scale and budget to make changes, while community health centers and federally qualified health centers have larger Small and disadvantaged, says Cesar Herrera.
In the partnership, which requires approval from the New York State Department of Health, Yuvo will contract with Fidelis through a value-based care arrangement, where both parties can tap into shared savings if certain goals are met. The partnership between the two New York City-based organizations provides an opportunity to alleviate the food, housing, transportation and socioeconomic insecurity experienced by Yuvo Health’s FQHC patients. It will focus on 13 clinical quality measures, including preventable admissions, readmissions and emergency department visits. Four FQHCs are part of Yuvo Health’s Association of Independent Providers: Long Island Select Healthcare, Metro Community Health Centers, Joseph P. Addabbo Family Health Center, and Advantage Care Health Center.
Fidelis Care is New York’s largest provider of Medicaid managed care, with more than 2.4 million members statewide. Herrera said its size — and that it’s statewide rather than just a region — attracted Yuvo to the partnership. The company provides data and analytics tools that will help Yuvo and its FQHC partners identify performance gaps and make improvements. Yuvo Health will work with its FQHC partners and use Fidelis’ technology and analytics engine to meet contractual requirements and maximize shared savings.
Yuvo declined to specify what the contractual obligations were, as those obligations were different for each FQHC.
The two-year partnership begins with a Tier 1, upside-only arrangement and will then transition to a Tier 2 risk reduction arrangement, according to Press Releases. In a Tier 1 arrangement, if there are cost savings, then the provider will share the cost savings. If there is any loss, the supplier will not be liable for the loss. In a Tier 2 arrangement, in the event of a loss, the provider will be liable for the loss. However, if there are savings, the provider will incur a larger percentage of the savings than a Tier 1 arrangement.
“That’s what makes us so excited: not only to be able to lock in this Tier 2 contract, but to be able to combine it with our largest Medicaid managed care plan in the state,” Herrera said.
FQHCs cannot undertake Tier 2 arrangements on their own, but because Yuvo Health qualifies, FQHCs have access through partnerships, Herrera said.
“Partnering with Yuvo Health ensures FQHCs have the technical and administrative support they need to thrive under a value-based arrangement that means better care for New Yorkers,” said Pantelis Karnoupakis Fidelis Care, vice president, Value-Based Payments Programs and Fidelis Care The risk adjustment is indicated in the press release. Fidelis Care did not respond to MedCity’s request for comment by press time.
Herrera said the goal of Yuvo’s partnership with the partnership is to demonstrate that enabling FQHC through value-based care can save money and help provide more care to Medicaid and uninsured patients. Yuvo eventually hopes to expand this model beyond New York and throughout the United States through other health plan contracts.
“Our goal is to be able to build as many of these relationships as possible for our FQHC partners because we want every patient to be attributed to some form of value-based care,” Herrera said.
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