Create an integrated, collaborative and accountable service delivery structure that incorporates the full continuum of care, eliminating service fragmentation while increasing the opportunity to align provider incentives. This project will facilitate the creation of this structure by incorporating the medical, behavioral health, post-acute, long-term care, social service organizations and payers to transform the current service delivery system from one that is institutionally-based to one that is centered on community-based care. Each organized integrated delivery system (IDS) will be accountable for delivering accessible, evidence-based, high-quality care in the right setting, at the right time, at the appropriate cost. These organized IDSs will commit to devising and implementing comprehensive population health management strategies and be prepared for active engagement in New York State’s payment reform efforts.
To achieve an integrated delivery system, the PPS must collaborate as a network providing a coordinated continuum of services to ultimately achieve the goals of improving efficiency, quality and access to care. This project helps increase the opportunity to align provider incentives through the use of population health management strategies and active collaboration. The goal of the project is to transition the health care delivery focus to value-based and evidence-based care by incorporating medical, behavioral health, post-acute and long-term needs.