Scaling Success: The Medicaid Model New York Can't Afford to Ignore | amNewYork

"Medicaid rewards volume. More visits. More procedures. More admissions. More of everything except better outcomes. The system prioritizes quantity over quality, remaining blind to whether care actually prevents the chronic conditions driving 80% of healthcare costs."

"We built a system designed to treat disease, not prevent it, and then questioned why costs keep rising. As New York faces a multibillion dollar budget gap and federal cuts threaten coverage for nearly half a million residents, this is a failure we can no longer afford."

"SOMOS is a nonprofit, physician led network of independent, community based doctors built to serve populations often left out of traditional systems. It recognizes that caring for vulnerable patients requires more than treatment. It requires prevention, education, and access."

The American healthcare debate has misfocused on costs rather than outcomes. Medicaid's structure rewards volume, leading to more procedures without improving health. This approach neglects prevention, contributing to rising healthcare costs. New York's Delivery System Reform Incentive Payment program aimed to shift care towards prevention and accountability but faced challenges. SOMOS Community Care emerged as a successful model, emphasizing prevention and education for vulnerable populations, demonstrating that a focus on value-based care can lead to healthier patients and cost savings.

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