Cityblock extends reach to New York Medicaid members with Fidelis Care partnership

Cityblock is expanding its services to Medicaid patients in the New York City area through a partnership with Centene-owned Fidelis Care.

Cityblock will collaborate with the health plan to provide primary care, mental health care and social services to thousands of members in the New York City area and Long Island living with complex medical and behavioral health conditions, the companies said.

The health plan serves more than 2.5 million members across New York state.

"Fidelis serves such a large proportion of people in New York, so our partnership is focused on bringing our model of comprehensive and community-based care to their Medicaid as well as their HARP members. We believe the partnership is strong because we're uniquely positioned together to reach such a large number of members," Kameron Matthews, M.D., Cityblock's chief health officer, said in an interview.

Fidelis Care shares Cityblock's vision for innovation and value-based care, Matthews said. "Our work together is more important than ever to close any gaps in care to those disproportionately impacted by the pandemic and economic changes over the last few years," she noted.

The New York City-based company, which launched in 2017 out of Alphabet's Sidewalk Labs, delivers medical care, behavioral health care and social services to individuals from historically underserved and marginalized communities, in particular those with complex needs. The value-based healthcare provider partners with managed care organizations to help address gaps and opportunities to improve access to care as well as improve quality and outcomes for high-risk and rising-risk populations, particularly Medicaid, dually eligible and lower-income Medicare beneficiaries, according to executives.

The company also partners with community-based organizations to address members' social needs, including food instability and access to safe housing, which disproportionately affect the health outcomes of lower-income communities.

"We're providing integrated care, focusing on the whole person, and we're focused on improving quality outcomes, reducing total cost of care, and most importantly, improving our engagement with these individuals who need to have access to services," Matthews said.

Cityblock's care model connects members to a multidisciplinary care team that includes primary care providers, behavioral health specialists, community health partners, nurse care managers, pharmacy navigators and more providers. Through this partnership, eligible members of Fidelis Care's Medicaid Managed Care and HealthierLife – Health and Recovery Plan (HARP) plans now have access to Cityblock's integrated care services. Members have the choice to see their care team virtually, in their homes or at local Cityblock clinics.

"By eliminating the barriers to healthcare, Cityblock and Fidelis Care will help improve the lives of our members," Vincent Marchello, M.D., Fidelis Care chief medical officer, said in a statement.

By offering 24/7 access and care, Cityblock's multidisciplinary care team helps reduce unnecessary emergency department visits and inpatient admissions while improving quality and member participation in their healthcare. 

Cityblock now has roughly 1,100 employees and says it partners with three of the top five national Medicaid health plans. It currently operates in New York, Massachusetts, North Carolina, Ohio and Indiana.

In 2022, it teamed up with MDwise, the second-largest Medicaid managed care organization in Indiana, to expand its primary care model into that state.

The company recently opened its first flagship health hub in Brooklyn. The hub is a 4,279-square-foot space with state-of-the-art clinical facilities and a community room.

Last month, the company announced it inked a partnership with Centene subsidiary Buckeye Health Plan in Ohio. Cityblock is working with the health plan to provide integrated community-based care to approximately 10,000 Medicaid recipients in the Cleveland-Akron-Canton area.

The value-based care provider has set its sights on serving 10 million members by 2030, which means scaling its operations, technology and care services.

Seven years after its founding, Cityblock is learning lessons by partnering with payers in different states as it expands its services to more patients.

"We are on a steady path as we continue to optimize our care model. We are focused on beneficiaries who have complex needs and who have disproportionately higher risk for poor health outcomes," Matthews said. "The more that our programs integrate services between physical, behavioral and social health, we are improving their outcomes. We're doing this with an equity focus by acknowledging and utilizing trauma-informed care. We're seeking to earn their trust. Our model is successful because we're able to do this in this value-based system. We're not focused on just transactional interactions, but we establish longitudinal relationships with our members, and we're holistically meeting their needs."

She added, "Our lessons learned are really what we had hoped from our founding—that we could meet a holistic set of needs for people and not just focus on physical health alone—and we're succeeding. Fidelis is very committed to achieving the same for its members, so this is just a natural partnership."

Cityblock aims to supplement what Fidelis brings to the table, Matthews said, notably "great benefits and a strong provider network."

"Our goal is to fill in the gaps. Where are the members' needs not being met, maybe due to some of their social needs, maybe because we're able to reach them a bit more effectively in their homes or in their communities? Fidelis is a strong entity within the New York City area. and this partnership is meant to just augment what they're already providing." 

Working with communities with complex needs is Cityblock's "bread and butter," Matthews noted.

"Our community health partners earn their trust and understand their needs and then they do all within their power to actually meet their needs. We coordinating groceries, we are coordinating transportation, we're helping them even complete applications for housing, for unemployment and helping them coordinate childcare when that's necessary because it's impacting that member's ability to take care of themselves," she said.

"Our community health partners are the crux of how we're able to address those social needs. We're serving these communities that are more marginalized, that are at higher risk and that have, in general, been traumatized, potentially, with their interactions with the healthcare system, so that trust that is built between the member and community health partner is pivotal to our success."

Cityblock's care model has shown increased engagement, higher retention rates and meaningful reductions in avoidable inpatient admissions, according to the company's 2024 Equity in Action report.

During the J.P. Morgan Healthcare Conference in January, Toyin Ajayi, M.D., CEO and co-founder, shared that the company continues to chart strong growth and posted north of $1 billion in revenue in 2023.

The seven-year-old company's revenue doubled in two years from half a billion dollars in 2021, Ajayi said. 

The company has raised nearly $900 million to date, including $160 million in December 2020, followed by $192 million in a series C extension in March 2021 and then a reported $400 million late-stage funding round in 2021.