FamilyHealth Accountable Care Organization (ACO), LLC was founded in 2012 and is led by three New York State federally qualified health centers (FQHCs): the Institute for Family Health (the Institute), Hudson River HealthCare (HRHCare), and Open Door Family Medical Centers (ODFMC). The mission of FamilyHealth ACO is to achieve the three-part aim - improve patient experience of care, improve health of populations served, and lower per capita costs - through better access to high-quality, patient-centered health care and care coordination services targeted to the needs of medically underserved communities.
FamilyHealth ACO aims to optimize health services delivery for Medicare fee-for-service beneficiaries who receive primary care services at any of the 48 health center sites operated by the participant FQHCs. The vast majority of FamilyHealth ACO patients reside in New York (Manhattan), the Bronx, Westchester, Rockland, Orange, Sullivan, Putnam, Ulster, or Dutchess counties. FamilyHealth ACO patients are predominantly low-income individuals with limited access to health care. A large proportion of these patients are chronically ill, often with co-morbid medical and mental health diagnoses. In alignment with Medicare Shared Savings Program goals, FamilyHealth ACO seeks to improve health service quality, improve outcomes and lower costs for these medically complex patients through a number of strategies, described below.
The three FQHCs are the sole participants of FamilyHealth ACO and are uniquely well positioned to achieve the goals of the Medicare Shared Savings Program. Each has several decades of experience and a history of growth: the Institute was founded in 1983 and today comprises 28 practice sites; HRHCare was founded in 1975 and now includes 22 sites; and ODFMC was founded in 1972 and today operates five centers. Together, the three organizations provide close to one million visits to nearly 200,000 patients annually, specifically targeting communities that face barriers to accessing high-quality health care. All three are accredited by the Joint Commission and hold Level 3 National Committee for Quality Assurance (NCQA) recognition as patient centered medical homes. All three regularly participate in federal, state and local efforts to improve health outcomes, including, for example, the New York State Medicaid Health Homes program. All three use electronic health record systems at all locations, and explicitly endeavor to leverage health information technology and analytics to improve health outcomes in medically underserved communities.
The three participant FQHCs also share a history of collaboration: in 2009, they founded Hudson Information for Community Health (HITCH) to formalize their shared commitment to undertaking large scale, collaborative clinical service delivery improvement projects in New York State's Hudson Valley region and beyond. Through HITCH, the three participant FQHCs have undertaken several multi-million dollar state- and federally-funded initiatives to improve care coordination, increase use of technology to support patient care, increase enrollment and retention in health insurance, and improve access to cancer screening.