Who We Are

What is the North Country Initiative?

north country initiative

The North Country Initiative — or “NCI” for short — is a partnership of hospitals, independent physicians, and community providers working together to reform the healthcare system across northern New York’s Jefferson, Lewis, and St. Lawrence counties.

With the healthcare system undergoing significant change at both state and national levels, we are working together to align incentives across our rural region, create clinical programs, and develop necessary health technology infrastructure. We believe that cooperating on all of these strategies will improve the health of our community, reduce the cost of healthcare, and improve care for patients.

Much of our everyday work is grounded in working toward four key goals:

  • Improving the quality and efficiency of care for the rural, under-served population
  • Providing accessible, effective, high quality healthcare
  • Aligning health system partners with payers to drive clinical improvement and add value to patients
  • Implementing evidence-based medicine to enhance patient outcomes


Our agency was one of 25 “Performing Provider Systems” participating in New York’s Delivery System Reform Incentive Payment Program. This program, commonly abbreviated to “DSRIP,” was a five-year initiative that aimed to transform and improve healthcare for New York’s Medicaid population. Together with our partners, we chose 11 different DSRIP projects, which focus on:

  1. Creating an Integrated Delivery System
  2. Creating Medical Villages using existing hospital infrastructure
  3. Implementing Care Transition protocols to reduce hospital readmissions
  4. Engaging the Medicaid population through Patient Activation measures
  5. Integrating primary care and behavioral health
  6. Using evidence-based strategies for cardiovascular disease management
  7. Using evidence-based strategies to manage diabetes
  8. Creating community resources for chronic disease management
  9. Strengthening mental health and substance abuse resources
  10. Increasing access to preventive care across the region, in both clinical and community settings
  11. Transforming primary care offices through the Patient Centered Medical Home model

For more information about the DSRIP program, click here.


public reportingHealthCare Partners of the North Country is our region’s Accountable Care Organization (ACO), aiming to align with federal policy reform and transformation.  ACOs exist to improve the quality of care for our Medicare population while focusing on strategies that reduce the cost of care.

Currently, HealthCare Partners of the North Country is aligning its efforts with the DSRIP program and working on strategies that are entirely patient-focused. Those strategies include care coordination, improving on annual wellness reviews, clinical management through national evidence-based guidelines as well as improving collaboration among our health care partners.

For more information about our ACO, click here.


NCI’s third major initiative is its Independent Practice Association (IPA), called the North Country IPA. This program uses the “messenger model,” in which participants have the opportunity to jointly contract with one or more payers — such as Managed Medicaid, Managed Medicare, or commercial insurers.

Participants in the North Country IPA include six hospitals, a Federally Qualified Health Center, five behavioral health providers, and nine independent primary care providers across Jefferson, Lewis and St. Lawrence counties.

Much like with the ACO, the IPA is pursuing value-based contracts that will require partners to collaboratively meet specified cost and quality benchmarks for their assigned patient population. The IPA will support partners in reaching the DSRIP and NYS VBP Roadmap goal to have 80-90% of Medicaid Managed Care payments to providers using at least Level 1 value-based payment methodologies by March 31, 2020.

The IPA anticipates contracting with the region’s two largest Medicaid Managed Care Organizations — United Healthcare and Fidelis Care — for a total cost of care arrangement, in which the IPA partners will assume responsibility for the outcomes and costs of their members. Additional opportunities with Managed Medicare and commercial payers are also being pursued for value-based contracting.