New York's 220+ acute care hospitals include some of the most complex and expensive medical institutions in the world. Northwell Health (23 hospitals, the largest health system in New York), NYU Langone, Mount Sinai Health System, NewYork-Presbyterian, and Montefiore Medical Center collectively operate under an extreme cost structure — clinical labor, real estate, and regulatory compliance costs in New York City exceed nearly every other US market. This cost structure exists alongside a massive safety net obligation: New York's public hospital system (NYC Health + Hospitals) is the largest municipal hospital system in the country, and Medicaid covers approximately 7.3 million New Yorkers, nearly 40% of the state's population.
The New York State Department of Health's Value-Based Payment (VBP) roadmap has set aggressive targets for shifting Medicaid payments from fee-for-service to population-based contracts. Systems must demonstrate performance on Total Cost of Care, Clinical Quality, and Utilization metrics that require not just data collection but genuine population health analytics at scale. Meanwhile, the Medicaid Global Cap — New York's mechanism for constraining state Medicaid spending growth — creates recurring fiscal uncertainty that ripples through DSH payments and supplemental payment pools that safety net hospitals depend on for financial survival.
Health systems like Northwell Health, NYU Langone, Mount Sinai Health System, NewYork-Presbyterian, Montefiore Medical Center, and Albany Medical Center face a market where Empire BlueCross BlueShield, UHC, Aetna, EmblemHealth, and MetroPlus Health Plan each impose distinct quality measurement frameworks. Managing HEDIS performance across commercial, Medicare Advantage, and Medicaid Managed Care contracts simultaneously — in a cost environment where a single FTE analytics hire exceeds $150,000 — demands automation that conventional BI tools cannot provide.
New York Medicaid managed care is administered through contracts with plans including MetroPlus Health Plan (NYCHHC), Fidelis Care (Centene), EmblemHealth, and WellCare. The NYSDOH requires encounter data submission through the eMedNY system with strict timeliness standards. Incomplete or delayed encounter data affects managed care capitation rates and triggers compliance reviews that can result in financial penalties.
New York's Delivery System Reform Incentive Payment (DSRIP) program, now transitioning into a new Value-Based Payment framework, required performing provider systems (PPSs) to track quality and utilization metrics across attributed Medicaid populations. The successor VBP arrangements embed the same population health analytics requirements into long-term Medicaid contracting. New York also maintains robust SPARCS (Statewide Planning and Research Cooperative System) hospital discharge data reporting requirements that serve as a foundation for public quality reporting and benchmarking.
Local EHR Footprint
Vizier connects to every major EHR running in New York via FHIR R4, HL7 v2, OAuth-based APIs, or scheduled exports. Each row links to the connector documentation for that EHR.
How New York Customers Use Vizier
Illustrative scenarios drawn from the patterns we see across New York health systems, practices, and ACOs. Not specific customer stories.
20,000 attributed lives across MSSP and a NY State APP arrangement. Quality director needed continuous attribution monitoring (NY APP attribution rules differ from federal MSSP) and HEDIS Value-Based Payment measure tracking. Vizier Epic FHIR + Clarity connectors at both systems gave one attributed-cohort view. Q3 reconciliation result was the first one in three years that didn't surprise leadership.
200-bed hospital + 12 FQHC clinics, mix of Cerner inpatient and eClinicalWorks ambulatory. Medicaid Global Cap and DSH payments require accurate uncompensated care + Medicaid encounter analytics. Vizier read both EHRs and produced one consolidated DSH eligibility model + supplemental payment trigger dashboard. Recovered ~$1.8M in supplemental pool revenue identified in year one.
9 sites, ~120K UDS patients, dental and BH integrated. NYC FQHCs face dense Medicaid Managed Care reporting (MetroPlus, Fidelis, EmblemHealth, Healthfirst, etc.) on top of UDS. Vizier connector + per-MCO HEDIS dashboards consolidated reporting that previously took three FTEs. Now done by one analyst with time left for outreach campaign analysis.
Connect your EHR live via FHIR or HL7, schedule a feed, or upload an export. Ask in plain English. Get clinical intelligence in 60 seconds. No six-month implementation. No per-seat licensing.