NCI’s second value-based contracting entity is its Independent Practice Association (IPA), called the North Country IPA. This program uses the “messenger model,” in which participants can jointly contract with one or more payers, such as Managed Medicaid, Managed Medicare, or commercial insurers. 

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Participants in the North Country IPA include hospitals, Federally-Qualified Health Centers, behavioral health and substance use providers, independent primary care providers, and community-based social care organizations across Jefferson, Lewis, and St. Lawrence counties. 

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Much like with the ACO, the IPA pursues value-based contracts that require partners to collaboratively meet specified cost and quality benchmarks for their assigned patient population. 

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The IPA currently contracts with the region’s two most prevalent Medicaid Managed Care Organizations (MCOs) for total cost of care arrangements, in which the IPA partners assume responsibility for the outcomes and costs of their members. In 2025, the IPA entered a third arrangement focused on individuals with BH needs and the BH care teams who serve them. This innovative contract is the culmination of Behavioral Healthcare collaborative efforts that began during DSRIP. In it, BH teams work to proactively manage individuals’ treatment and medication, avoid acute inpatient BH stays when feasible, and quickly follow up with individuals after BH-related inpatient or emergency department visits. Additional opportunities with Managed Medicare and commercial payers are also being pursued for value-based contracting.
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For more information about becoming a member of the North Country IPA, please CLICK HERE.