Thursday, May 7, 2020

SOMOS INNOVATION—the post-DSRIP future






As our city, our state, our nation and our world are struggling with the coronavirus pandemic, I first of all want to express my gratitude and admiration for your work on the frontlines of caring for coronavirus victims and protecting New Yorkers across the board. May you and your staff stay safe—and know you have the support of the entire SOMOS organization.

As you know, the DSRIP program formally concluded on March 31, 2020. It is a great disappointment that federal and state authorities opted not to renew the program’s mandate despite DSRIP’s many achievements. However, SOMOS will continue it groundbreaking work on behalf of the city’s poorest patients through SOMOS INNOVATE. It’s with an eye on that new chapter that I have drafted these notes.

The following draws on the recommendations and observations found in a report produced by the Helgerson Solutions Group (HSG), which earlier this year completed a strategic audit of SOMOS, precisely to map out its post-DSRIP future. HSG’s founder and principal is Jason Helgerson, the former New York State Department of Health Medicaid director and visionary behind DSRIP. He and this team know the health-care landscape intimately. It is a landscape being radically transformed by the Value-Based Payment (VBP) model and SOMOS INNOVATE will be our doctors’ guide and advocate.

As such, the HSG report proclaims that SOMOS INNOVATE is “about more than just being a VBP innovator. … SOMOS has the potential to revolutionize health and social care … and being a light in the wilderness for physicians and physician groups around the country.” As pioneered by DSRIP, the VBP model, a move away from the traditional Medicaid  fee-for-service payment formula, allows networks of independent physicians to bypass hospital systems and “contract directly with insurers (or the government) and take control of the total health care dollar and the flexibility those payment models offer to revolutionize care.”  With SOMOS INNOVATE at their side, our doctors can continue “to rise up and take control of their own destiny.”

SOMOS INNOVATE will continue the transformation of health care for New York City’s most vulnerable patients by continuing to “institutionalize cultural competence, empower patients and address the true root causes of bad health and social outcomes.” The fact that so many of our doctors share the same cultural background as the people they serve makes for “an exceptional closeness to their patient base, something that is very hard to achieve and harder to replicate by other organizations.”




To strengthen its clout and grow our network of providers, SOMOS INNOVATE will aim to engage other IPAs. It will also put a premium on partnerships with Community-Based Organizations to address Social Determinants of Health, a critical component in providing patients with comprehensive, wholistic care. Such care has the power to improve “community happiness” by “fully embrac[ing] the health, social and economic needs of the community.” It’s a model of care that revolves around the neighborhood-based primary care physician as trusted community leader.

To stave off competition, SOMOS INNOVATE will consider establishing “creative partnerships” with hospitals which might otherwise make access to specialty care more difficult. It will also pursue VBP contracts with Managed Care Organizations that would welcome SOMOS INNOVATION as a hospital competitor.

SOMOS INNOVATION has been operational for some time and continues to implement a rapid development strategy. The SOMOS Board of Directors appointed 20-year health-care industry veteran Dan McCarthy as CEO of SOMOS INNOVATION. An expert in value-based care, Dan has spent the bulk of the past year building up the organization and putting in place his management team.

The time is now, says the HSG report: “SOMOS is on the right side of health-care history. After years of delay, the health-care world is finally starting up really embrace value. New York State and Medicare are continuing their push to get virtually all providers into the VBP arrangement.” The goal is to position SOMOS INNOVATION on the forefront of publicly funded health-care innovation, state-wide and even nationally.

Achieving that objective will be critical if SOMOS INNOVATION is to succeed in enabling its doctors to remain competitive in a time of rapid change and in the face of the potential challenge of the Big Four—Apple, Google, Amazon and Microsoft—entering the arena of “technological innovation that will revolutionize the provision of many health-care services over the next decade,” stresses HSG.

In the form of robotics and Artificial Intelligence, “technology may replace as much as 80 percent of what doctors currently do and SOMOS will need to stay ahead of that curve on their physicians’ behalf.” A premium must be put on building “productive partnerships between doctors and machines.” Increasingly sophisticated technology will free up doctors from “routine tasks so that they can re-focus their time and attention to supporting their patients psychologically and helping them understand—as well as act upon—their medical condition.” Surely, this increasingly intimate attention paid to patients will be essential for delivering optimal value-based care.





Among the technological tools of the future will be smartphone apps that allow for 24/7 monitoring of patients. There will be sharp growth in the kinds of “wearable technology, biometric sensors as well as apps,” all working in sync to create an “Internet of the body.” “Doctors in the future will prescribe apps” allowing for patients’ self-diagnosis. Overall, technology will drive a “long-term shift from managing sickness to preventing it.”

The report says that in future, doctors may well be “dispensing their advice through chatbots, instant messaging and video calls instead of sitting in an office with a line of patients to see them.” Noting that SOMOS doctors “already excel at some of the inter-relational aspects of the job by virtue of being in, and of, the community in which they serve,” they will need training in acquiring a “new basket of skills” “to make the pivot to a more interpretative and context-providing role on its own.”

HSG notes that telemedicine, remote patient care, will have a $130B market share by 2025; and “the healthcare artificial intelligence market is projected to reach $19B by 2026.” All that innovation means that “the future of medicine will be more precise, personalized, participatory and preventive. These attributes align perfectly with SOMOS’ existing values.”

Indeed, helping and training our doctors “plan and prepare for the technological disrup4tions of the future” will be a hallmark of SOMOS INNOVATION. It is part and parcel of its overall commitment to empower our providers to offer the best possible care to New York City’s most vulnerable patients, and to bring about lasting reform of publicly funded health-care delivery.



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