What is the Cohort Management Program?
Care Compass Network’s (CCN) Cohort Management Program is designed to support the active management of priority Medicaid population cohorts, whereby partners from networks, integrate services, and are held jointly accountable for population outcomes. This type of collaborative network is not new – there are small and large-scale networks occurring across New York State.
The goal of this formalized program is to help our partners transition to a new Value-Based Payment (VBP) model where outcomes are incentivized rather than paid as a fee-for-service. Through the cohort Management Program, each Network will develop the necessary skills to work in a Managed Care environment, strengthen connections and relationships, learn how to administer funds differently, and learn how to work in a new payment model.
Cohorts is a set of individuals, defined by characteristics or triggering events. A cohort may be a static group of individuals or dynamic, meaning the group members change over time.
Community Based Organization (CBO) Tier Levels
Tier 1: Non-profit, non-Medicaid billing, community based social and human services organizations (e.g. housing, social services, religious organizations, food banks, and mobility management)
Tier 2: Non-profit, Medicaid billing, non-clinical service providers (e.g. transportation and care coordination)
Tier 3: Non-profit, Medicaid billing and clinical service providers licensed by the NYS Department of Health (DOH), Office of Mental Health (OMH), Office for People with Developmental Disabilities (OPWDD), Office of Addiction Services and Supports (OASAS), and independently owned primary care
Other: Any organization that does not meet all characteristics of the definitions above (e.g. a for-profit organization)
Value-Based Payment is an approach that rewards quality outcomes and improved patient care, requiring providers from across the care continuum to work together to improve patient care. This is a patient-centered approach where all providers work together to improve quality of life.
Value-Based Payment Lead Contractor (VLC) serves as the network lead for contracting with CCN. The VLC is an entity that is likely to lead contract negotiations with a Managed Care Organization (MCO) on behalf of a network.
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