Yuvo Health, a startup that offers value-based contracting services, and Centene Corp. subsidiary Fidelis Care are partnering to expand resources for federally qualified health centers in New York.
The centers provide services such as preventative care, specialty services and behavioral health resources for underserved populations, while also addressing socioeconomic barriers. They qualify for federal funding and enhanced reimbursements from Medicare and Medicaid. Charges are based on a patient’s income.
Yuvo takes on downside risks for the community health centers and helps negotiate contracts with shared savings, which are funneled to the health centers. Fidelis, the largest Medicaid managed-care provider in New York, handles reimbursements. With the partnership, Fidelis, the largest Medicaid managed-care provider in New York, can include members in value-based deals, when most health centers would otherwise not qualify for standalone agreements.
“We feel very strongly in our ability to increase their capacity to serve,” said Cesar Herrera, CEO and co-founder of Yuvo. “How we think of it in terms of transforming is by showing proof that this model is sustainable and it’s scalable. … The model itself is not necessarily novel.”
Yuvo was founded in 2021 and earlier this year raised $7.3 million in seed funding.
It plans to partner with other managed-care providers in New York.The two-year partnerships begin with the health centers not sharing in any losses and then evolve into a level 2 mitigated-risk model, where the centers share part of any loss. Herrera said Yuvo must ensure the health centers are able to withstand added risk.
Fidelis did not respond to requests for more details.
Yuvo recently partnered with four independent federally qualified health centers, including Long Island Select Healthcare, a Suffolk County, New York-based center that got its start serving people with intellectual and developmental disabilities. The center’s CEO, James Powell, said the partnership helps with workflow improvement and community engagement. It would otherwise have taken years to build this level of support, he said.
These partnerships also provide resources for understaffed centers to maintain quality, said Miriam Vega, CEO at the Joseph P. Addabbo Family Health Center, which has locations in isolated areas between Manhattan and Long Beach. The center hopes to use the shared savings through the partnership to invest in new programs such as a diabetes wellness center, she said.
Vega said despite limited resources, the health centers play a vital community role.
“We provide so many essential services, and during the pandemic especially … the government, the White House, depended on community health centers such as Addabbo to do COVID testing, to do the vaccine, and we didn’t get really reimbursed for those services,” Vega said.
Yuvo wants to expand beyond New York, Herrera said. It hopes to enter Ohio in 2023, followed by potential expansions into Michigan, New Jersey, Pennsylvania and the Washington, D.C., area.