Benefits

CNY AIM Benefits

How does my primary care practice benefit from joining the CIN?

Some benefits of CNY AIM participation for Primary Care Physicians include:

  • Support to advance to level 3 PCMH Eligibility for PCIP fee schedule enhancement (+3%/+6%) for ACQA participation
  • Access to embedded Health Coaches and Patient Navigators
  • Ability to participate in MSO offerings (including, but not limited to, group purchasing, patient satisfaction survey, professional liability)
  • Improved communication with Specialists
  • Participate in Commercial, Medicare Managed, and Medicaid Managed gain share contracts; eligible for shared savings

How does my specialty practice benefit from joining the CIN?

Some benefits of CNY AIM participation for Specialists include:

  • The ability to maintain and grow their referral base
  • Participate in Commercial, Medicare Managed, and Medicaid Managed gain share contracts; eligible for shared savings
  • Participate in network development and development of best practice protocols and metrics which will be the basis of VBP contracts
  • Ability to participate in MSO offerings (including, but not limited to, group purchasing, patient satisfaction survey, professional liability)

If your practice has a better contract with a health plan than CNY AIM, your practice could/should retain its current contract. Your practice may opt out of participation of classes of contracts and is also free to contract independently with health plans with which CNY AIM does not secure contracts with.

 

Your group’s effective participation date in CIN sponsored contracts is dependent on several external factors including, but not limited to: payer requirements, the ability of the practice to connect with 3 the CIN data aggregator, and the ability of the CIN and practice to staff appropriately for participation in risk contracts.

In our experience, specialty practices that opt to sign as "incentive participating" members have opted to do so because they have service line contracts in place with several hospitals and/or they want to ensure that they are not favoring one hospital or clinically integrated network over another.

The proceeds from any shared savings will be distributed by the payer to CNY AIM. CNY AIM will distribute directly to the practices based on the shared savings distribution formula that is developed, determined, and approved by the members of the CIN Management Board.

If the CIN fails to meet quality metrics/shared savings goals with a health plan, the CIN may be ineligible to receive earned shared savings.

Any distribution will ultimately be decided and approved by the members of the CIN Management Board. It is reasonable to conclude that gain-share distributions, in the future, will be tied to performance and that performance on quality metrics/shared savings goals could conceivably increase/decrease the amount of the distribution that your practice is eligible for.

Metrics for each performance year are mutually agreed to by the Payer and the CIN. These discussions occur at the direction of CNY AIM’s Quality Improvement and Population Health Committee.

ACO /GPRO metrics under the shared savings program are determined by CMS each performance year. CMS will measure quality of care using nationally recognized quality measures in four key domains:

  1. Patient/Caregiver Experience
  2. Care Coordination/Patient Safety
  3. Clinical Care for At-Risk Population
  4. Preventive Health

No, practices can join at any time.