Concordia Healthcare is a new clinically integrated network (CIN) across upstate New York that will support population health management. This is not a health system merger. It will be a new New York LLC with its own governance structure, management team and brand name. This new company allows health systems, physician organizations, and other healthcare providers to retain their independence yet work together as members of the network to:

• Create a network of providers and services across the care continuum serving upstate New York
• Provide increased access and better outcomes through improvement of our communities’ health status at a lower cost
• Establish a seamless, consistent, innovative, and coordinated patient experience across the network of providers
• Work with payers and employers to bring innovative and affordable products to market aimed at reducing total cost of care while simultaneously improving quality and the health of the communities we serve
• Shape the future of healthcare rather than react to it

Healthcare in New York is rapidly moving toward an environment where physicians, hospitals and other healthcare providers will be paid based on their ability to optimize the overall patient experience, to improve the quality and outcomes of care, and to reduce total cost of care (i.e. value-based care). With this transition to value-based care, payers and employers are increasingly seeking “organized systems of care” that can provide high quality, low cost patient experience and outcomes. The complementary geographic presence across upstate New York and low cost, high quality performance of the partner physician organizations makes Concordia Healthcare attractive to payers seeking value-based performance in contracting.

No. While some health systems in New York have organized systems of care through mergers and acquisitions of hospitals and physicians into one system, Concordia Healthcare’s approach is instead to create an organization that will clinically integrate a network of independent health systems, physician organizations and pre- and post-acute providers across upstate New York through investments in technology, clinical management best practices and care coordination services. Clinical integration of providers across the continuum of care to provide coordinated, high quality, low cost healthcare services is aligned with the future direction of healthcare delivery.

The systems share a common vision on population health management and physician leadership as well as a complementary geographic presence to offer substantial breadth and depth of services to the communities they serve. They are committed to making Concordia Healthcare attractive to payers, physicians, employers, and consumers seeking value-based performance in contracting. This collaboration enables the systems to more efficiently resource, and accelerates the transition to population health. The health systems selected to participate in Concordia have a shared history of service to communities across upstate New York and are currently leaders in both cost and quality.

Clinical integration allows Concordia Healthcare in-network providers to share their best practices in clinical management and deliver more coordinated care to accomplish the Triple Aim and goals of population health management. Clinical integration allows physician and hospital providers to retain their independent organizations yet jointly demonstrate value and offer new health plan options for payers, employers and individuals seeking value-based care.

Concordia Healthcare will establish contracts and provide supporting resources and infrastructure to support local CINs, physician organizations (POs), and other in-network providers in four key areas:

1. Network Development– building a network of healthcare providers across all specialties and sites of care to provide increased access for patients, determination of provider eligibility; developing recruitment approach
2. Operations/Information Management – integrating and analyzing healthcare information from all network providers to reduce duplication of services and track and improve the cost, quality and health of the populations served; development of performance metrics; creation of technology platforms to enhance relationships with payer and employers
3. Quality/Performance/Care Management – integrating and developing guidelines, clinical processes, protocols, and services to coordinate patient care effectively and efficiently
4. Finance/Contracting/Risk Management – financial and actuarial management services to develop, execute and manage health insurance products/contracts in partnership with payers and employers; development of risk management strategiesConcordia Healthcare will not be a mechanism through which to employ physicians.

Several physicians have been involved in the planning and development process from the very beginning of the planning stages of Concordia via participation on the Steering Committee. This committee met monthly for two years and has been integral to the design and development of the organization. For example, their guidance drove the design of the governance structure, selection of the first Board members, and the contracting approach.

Concordia Healthcare has been designed as a collaboration between health systems, CINs and its physician partners. The initial Board will include physicians, system executives and community at-large members. Members of the committees will be appointed by the Board and comprised of Network members at-large in good standing. The committees include: Contracting & Financing, Quality & Performance, Network Development and Management and Operations. These committees will be instrumental in decision-making regarding contracting, performance measurement, funds flow, network development and eligibility, etc.

The Board is established to have general powers to run the organization, with Sponsor/System reserve powers only to be exercised on an exception basis. The Board’s responsibilities include: approval of contracts, strategic plan and operating budget; election of the Board officers; appointment of the Board Committee members; and joint appointment and removal of the CEO along with the Systems/Sponsors.

Concordia Healthcare’s participation agreements have been developed and distributed to a select number of preferred partners as part of the initial growth phase. Additional partners will be identified and selected by the Network Development and Management committee.

No. Concordia Healthcare is not an exclusive network. Providers can join Concordia Healthcare and retain membership in other networks.

How will Concordia Healthcare handle contracting on behalf of the network members? Concordia Healthcare will be focused on establishing new, population-based contracts where legally appropriate given levels of clinical and financial integration. In the near term, the only contracts that Concordia Healthcare has flexibility to enroll its network members into are upside-only arrangements overlaid on existing fee schedules, where the payments for delivering care are already established in current PO contracts, but Concordia Healthcare could contract for care management and/or performance incentive funds as overlay payments for performance against volume and value metrics. POs will not be required to terminate or transfer existing contracts to Concordia Healthcare. Concordia Healthcare will not be negotiating fee-for-service contracts.

No. Concordia Healthcare is a clinically integrated network of healthcare providers that will partner with payers and employers to bring affordable, high-quality health plans to upstate New York.

Physicians and their PO business leaders will be encouraged to learn more about the benefits of joining Concordia Healthcare over the coming weeks and months.

The Board and Committees of Concordia will be working with payers and employers to design and launch affordable, high quality health plan products and services centered on the emerging network of providers. Stay tuned.