Montefiore Medical Center, an academic medical center in New York City, has created an integrated system of care for its primarily low-income patients. This patient-centered system of hospitals, community clinics, and school-based clinics uses innovative practices for managing chronic disease, provides access to high-quality specialty hospital care, and employs targeted care management and robust health information technology in support of integrated care. Although close to 80 percent of its payer mix is Medicaid and Medicare, Montefiore has been able to achieve financial and organizational sustainability. Factors that contribute to this success include: care management that allows for integration across the system; building successful primary care that combines traditional and new models; and medical systems that focus on population health and community accountability.
This study was based on publicly available information and self-reported data provided by the case study institution(s). The aim of Commonwealth Fund–sponsored case studies of this type is to identify institutions that have achieved results indicating high performance in a particular area of interest, have undertaken innovations designed to reach higher performance, or exemplify attributes that can foster high performance. The studies are intended to enable other institutions to draw lessons from the studied institutions' experience that will be helpful in their own efforts to become high performers. Even the best-performing organizations may fall short in some areas or make mistakes—emphasizing the need for systematic approaches to improve quality and prevent harm to patients and staff. The Commonwealth Fund is not an accreditor of health care organizations or systems, and the inclusion of an institution in the Fund's case study series is not an endorsement by the Fund for receipt of health care from the institution.