For exceptional performance, eligible participating physicians will receive an estimated 1.68 percent increase in merit-based payments from CMS
ALBANY, New York – The Innovative Health Alliance of New York (IHANY), a high-performing network of doctors, health systems and other health care providers in New York’s Capital Region aimed at improving the health of the communities they serve, achieved a perfect score on key quality and performance measures tracked by the Centers for Medicare & Medicaid Services (CMS).
IHANY scored 100 out of a possible 100 on its 2018 Merit-Based Incentive Payment System (MIPS) score. For achieving this high score, eligible IHANY physicians will receive an estimated additional 1.68-percent increase in payments – essentially a bonus – as an “exceptional performance adjustment” from CMS. The payment adjustment will go into effect in 2020. The exact percentage of the increase could change slightly as CMS finalizes its calculations.
The high MIPS score and performance-based payment increase reflect the value of IHANY to participating health care professionals, health care organizations, payers, and – most importantly – to patients.
“Our final MIPS score reflects the value of Capital Region physicians and health care organizations working together, and focusing our limited resources on common goals that ultimately lead to better care for our patients,” said IHANY Board President Paul Barbarotto, D.O., who practices at Capital Region Family Health Care, a practice of St. Peter’s Health Partners Medical Associates. “There is still much work to be done, but this is an important milestone and every IHANY participant should be proud of what we have accomplished together.”
Formed in 2014, IHANY is the Capital Region’s first Clinically Integrated Network (CIN), and is a CMS-approved Accountable Care Organization (ACO) and New York State All-Payer ACO.
While legally owned by St. Peter’s Health Partners (SPHP), IHANY is a true community network that is both physician-governed and physician-led. IHANY brings together more than 1,500 participants including private physician groups, health care systems including SPHP, Ellis Medicine, St. Mary’s Healthcare in Amsterdam, and other health care providers such as the local federally qualified health centers Whitney M. Young Jr. Health Center and Hometown Health Centers. Together, their mission is to increase the quality and lower the cost of care, in order to improve the overall health of the populations they serve, by participating in new methods of payment and reimbursement. This mission is closely aligned with CMS’s stated goal for its Medicare program.
One way CMS is moving toward its goal is transitioning to value-based programs, which aim to reimburse health care providers and systems based on the quality of care they provide – often referred to as Population Health. In turn, CMS is transitioning away from the traditional fee-for-service model, which reimburses providers and systems based solely on the volume of care provided.
“We are truly building a community ecosystem, to support all members of the Capital Region health care community, so we may collaborate and learn together how to best navigate and succeed in a landscape where payment is quickly moving away from fee-for-service and toward Population Health,” said IHANY Chief Executive Officer and SPHP Chief Strategy Officer Leslie Barden. “Our MIPS score and related payment adjustment clearly demonstrate how collaborating through IHANY, and being ahead of the curve in Population Health, translates into real value and higher revenue for participating providers.”
As an ACO, IHANY handles much of the administrative and regulatory complexity and requirements for its participating providers. Additionally, it has built the infrastructure and expertise needed to be successful under value-based payment models.
CMS MIPS scores are compiled from patient and provider data collected by CMS from providers, across four categories: quality; cost; promoting interoperability (proactively sharing patient information with other clinicians); and improvement activities (for example, enhancing care coordination or expanding access to certain services).
The Innovative Health Alliance of New York, LLC (IHANY), is the Capital Region’s first Clinically Integrated Network (CIN). This physician-directed multi-provider network is designed to control health care costs and ensure patient care quality by enabling its more than 1,500 participants to work together in joint contracting and share incentive-based payments. IHANY is also an approved Accountable Care Organization (ACO) for the Medicare Shared Savings Program and a New York State All Payer ACO. Learn more at www.ihany.org.