How A NYC Hospital System Reconstructed Itself to Better Deliver Value

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Mount Sinai Health System, which serves more than four million patients per year, took the critical step of transforming the system’s former fee-for-service business model and restructuring its organization with value-based care at the forefront.

The transformation began when leadership teams reconstructed the organization from the top down, first creating a new department devoted to care management in a VBC model. Mount Sinai also built an integrated team for population health, restructuring finance, contracting and clinical programs by reimagining job descriptions and the role of primary care within a purpose-built model.  

The new model delivered results in the first year, with the volume of emergency room visits reduced by one-third in one case study at a primary care health center. The monumental shift came after Mount Sinai was incentivized to spend necessary time with patients to focus on prevention, referring out to a specialist only when necessary as well as expanding hours of the health center and conducting significant community engagement, reaching out to patients with chronic illness.

Niyum Gandhi, executive vice president and chief population health officer, sees embarking on a proactive approach to value-based care as a leadership responsibility.

“We're here to serve the community and this is a higher value way of serving the community, and that return will come in the future,” he said.

More information on the 3D Model of Value-Based Care can be found here