Serious Illness Approaches by ACOs: NYC Health + Hospitals ACO (HHC ACO Inc.)

NYC Health + Hospitals (NYC H+H) is the largest public hospital system in the country and the main health care provider for many vulnerable New York City residents, including a large fraction of Medicaid and uninsured patients. Compared to other ACOs in the Medicare Shared Savings Program (MSSP), NYC H+H’s ACO, HHC ACO Inc., is an outlier with 70% of its attributed patient population either dually eligible for Medicare and Medicaid, disabled, or diagnosed with end-stage renal disease. Furthermore, its patients are more likely to have social risk factors, such as challenges in housing, economic resources, food, or transportation.

The hospital-led ACO has participated in the MSSP since 2013 and currently has a total of 10,000–12,000 attributed patients. The ACO provides services at 11 hospital-based clinics, 6 large ambulatory care centers, and a city-wide network of community-based clinics whose structure is similar to Federally-Qualified Health Centers (FQHCs).