NEW YORK GOVERNOR ANDREW CUOMO has authorized a network of independent doctors in New York City to give the coronavirus vaccine to some of the city’s poorest residents, the bulk of them people of color—communities that have been underserved thus far in the distribution of the vaccine. SOMOS Community Care, a network of 2,500 physicians—most of them primary care physicians serving 1 million Hispanic, Asian-American, and African American Medicaid patients—will be given up to 1 million doses of the vaccine.
At a March 26, 2021 news conference in the Bronx announcing the move, Gov. Cuomo said that “the state is going to be providing vaccines directly to SOMOS so they can get those needles in those arms in those hard-to-reach communities.” The governor noted that New York City’s vaccination efforts have thus far failed to give sufficient access to minorities.
“We need to do vaccine equity,” he said, noting that, for example, the city is 27 percent black, yet only 19 percent of that population is vaccinated; by contrast, the city is 53 percent white and already 55 percent of these residents has been vaccinated.
Initially, 75 SOMOS medical practices will begin distributing the vaccine in the coming weeks; 100 practices will be involved in the effort pending supply of the vaccine. That means patients can make an appointment directly through SOMOS (somosvacunas.com), go to their regular doctor and get vaccinated right in the doctor’s office.
Thus far, New York State has relied primarily on hospitals and other medical facilities to distribute the vaccine, an infrastructure that is harder to navigate and gain access to for the poor, especially people of color. What’s more, Blacks and Hispanics, stressed the governor, have “less trust in the system” and have been skeptical about the safety and efficacy of the vaccine.
SOMOS doctors will rely on their unique relationship with their patients to create a level of trust and comfort, moving people to become willing to be vaccinated. That strong doctor-patient bond—with the physician functioning like the family doctor of old—hinges on several factors:
The majority of SOMOS doctors speak the same language and share the cultural background of the people they serve and in whose communities the physicians are based. This cultural competence has proven to be key factor in doctors understanding the needs of the people in their care.
The SOMOS network also puts a premium on the contribution of Community Health Workers, who visit patients’ homes, reminding them of medical appointments and assessing circumstances in the home or family that can impact people’s health. The latter fall in the category of the Social Determinants of Health—substandard housing, unemployment, criminal justice issues, etc. SOMOS doctors work closely with Community-Based Organizations that can address some of the issues.
SOMOS physicians also carefully integrate behavioral health into patients’ overall treatment. In sum, SOMOS doctors’ offices are a gateway to quality, holistic, comprehensive care, which makes for better longer-term health outcomes; and the doctors are compensated accordingly, earning more as their patients do better and, for example, stay out of costly hospital beds.
SOMOS has been functioning in accord with the Value-Based Payment system that rewards superior care—in contrast with the transactional payment formula of the traditional Medicaid model that is prone to waste and fraud.
SOMOS got its start thanks to Gov. Cuomo authorizing, in 2014, the Delivery System Reform Incentive Payment program, which ran through 2020 and laid the foundation that enabled SOMOS to provide superior care to New York City’s poorest residents. A new chapter in the SOMOS record of service to the most vulnerable has now begun with the vaccination program.
In his remarks at the news conference, Dr. Ramon Tallaj, founder and chairman of SOMOS, recalled that this is not the first time that New York’s governor called on the organization for vital aid. In March 2020, right at the start of the pandemic, the governor asked SOMOS to begin testing staff at the New York Stock Exchange, which it would do through the summer. SOMOS ran numerous testing sites throughout the city—as well as in Texas, Florida, and Georgia. To-date, said Dr. Tallaj, SOMOS has administered 1 million test and helped distribute 2 million meals to New York families hard-hit by unemployment as a result of the economic fall-out of the pandemic.
SOMOS doctors have success with their patients, said Dr. Tallaj, because “we understand their culture—because we are immigrants like them, we are the same people … we serve poor people in our neighborhoods, near their homes, near their apartments, because medicine is local and because people tend to choose doctors based on their values.”
Speaking of SOMOS’ new task, Dr. Tallaj said that his doctors—“champions of preventive medicine”—will distribute “the vaccine of hope to end the virus of loneliness, which has people dying.”
Mario J. Paredes is CEO of SOMOS Community Care, a network of 2,500 independent physicians—most of them primary care providers—serving close to a million of New York City’s most vulnerable Medicaid patients.
