What SOMOS Community Care does

SOMOS Community Care is a nonprofit, physician-led integrated healthcare network headquartered in the Bronx, New York, serving over 1 million Medicaid and Medicare beneficiaries across all five NYC boroughs and Nassau County. Founded in 2014 as a Performing Provider System under New York's DSRIP program, the network comprises over 2,500 culturally competent providers operating from 700+ locations, with a differentiated focus on immigrant, Latino, and underserved communities of color. The organization operates the only successful total cost of care Value-Based Payment (VBP) model implemented by a physician-led group in New York, managing Level-3 full-risk capitation contracts and generating $35-48 million in annual system savings with a 90% ACO quality score.

The company's core products combine clinical care delivery with social determinants of health (SDOH) interventions. Clinical offerings include primary care, specialty care, behavioral health, and maternal health programs. Social services span housing assistance, food and nutrition programs, transportation, and justice reintegration support, all integrated under a Social Care Network (SCN) operating pursuant to New York's 1115 Waiver. Technology infrastructure includes a RHIO-integrated Electronic Health Record system, the MiSOMOS patient-facing mobile application (launched 2019), the FindHelp self-serve social care navigation platform, a telehealth platform, and an emerging AI healthcare support tool developed in partnership with NYU Langone.

SOMOS generates revenue through multiple value-based payment streams: capitated Medicaid payments from Managed Care Organizations, Medicare ACO shared-savings arrangements, and NY 1115 Waiver-funded HRSN services delivered through the SCN. With a leadership team led by Founder/Chairman Dr. Ramon Tallaj and CEO Mario J. Paredes, SOMOS has positioned itself as a federally validated model for health equity, evidenced by meetings with HHS Secretary Becerra in 2023 and recognition including a 2021 Modern Healthcare Innovator Award and a 2022 NY Emmy.

Name

SOMOS Community Care

Legal name

SOMOS Healthcare Providers, Inc.

Website

https://somoscommunitycare.org

Company type

Private

Founded year

2014

Operating status

Operating

Headcount range

101–250 employees

Short description

SOMOS Community Care is a nonprofit, physician-led network of 2,500+ culturally competent providers delivering value-based primary, specialty, and social care to over 1 million Medicaid and Medicare beneficiaries across New York City and Nassau County, operating the state's only provider-led total cost of care VBP model.

Ownership category

akta.pro rank

Product category

Value-Based Healthcare Services

NAICS

Ambulatory Health Care Services (621), Social Assistance (624)

SIC

Services-Offices & Clinics Of Doctors Of Medicine (8011), Services-Health Services (8000)

akta.pro primary industry

Primary Care Networks, Groups & MSOs (HLAFAGAE)

akta.pro secondary industries

Primary Care for Underserved Populations (e.g., migrant, homeless, refugee clinics) (HLAFAGAN), Medicaid Managed Care HMOs (HLAEAMAI), Post-Acute Care Networks & Care Management Organizations (HLAFAFAN), Medicare Provider Networks & Delegated Medical Groups (MA-focused) (FSAIAGAK)

Keywords

• Value-based care
• Medicaid managed care
• Social care network
• Care coordination services
• Accountable care organization

Headquarters

HQ city

New York

HQ country

United States

HQ region

North America

Offices3 records

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Operations, Infrastructure, Technology or R&D, Marketing or Sales, Supply Chain

Revenue model

1. Value-Based Payment Contracts: Full-risk value-based payment contracts where SOMOS receives capitated payments to manage patient care. Generates savings by reducing ER visits, hospitalizations, and improving preventive care outcomes. As the only successful total cost of care VBP model implemented by a physician-led group.
2. Accountable Care Organization Revenue: Medicare ACO model generating $35-48 million in annual savings while maintaining 90% quality scores. Revenue derived from shared savings arrangements with Medicare.
3. Social Care Network HRSN Services: Health-Related Social Needs services under NY Medicaid 1115 Waiver including housing assistance, transportation, nutrition programs, and case management. Funded through SCN ecosystem.
4. Medicaid Capitation: Capitated payments from Medicaid managed care organizations for covered lives across the provider network.

Pricing tiers

Go-to-market motion3 records

Distribution channels4 records

Marketing channels5 records

Core offering

SOMOS Community Care operates a physician-led network of over 2,500 culturally competent healthcare providers delivering primary care, specialty care, behavioral health, and pharmacy services to more than 1 million Medicaid and Medicare beneficiaries in New York City and Nassau County. The organization pairs clinical care delivery with a Social Care Network addressing health-related social needs (housing, food, transportation, case management) and operates the only successful total cost of care Value-Based Payment model implemented by a physician-led group in New York.

Product overview

SOMOS Community Care operates as a physician-led, nonprofit integrated healthcare network combining clinical care with social services. The core offerings include a provider network of over 2,500 healthcare providers delivering value-based care to over 1 million Medicaid and Medicare beneficiaries, alongside the Social Care Network (SCN) addressing health-related social needs. The product portfolio spans clinical services (primary care, specialists, behavioral health, maternal health) and social determinants interventions (housing, food, transportation, care management). Key platforms include the MiSOMOS mobile app for patient access and a technological platform integrating EHR, RHIO connections, and telehealth capabilities. The Value-Based Payment model serves as the financial framework rewarding quality outcomes.

Differentiator

Problem solved

Functional benefit

Products and services

• MiSOMOS Health App Mobile health application available on iOS and Android enabling patients to access health services, managed care information, and connect with SOMOS network providers.
• Social Care Network (SCN) Social care network operating under New York's 1115 Waiver that connects Medicaid members with health-related social needs services including housing assistance, transportation, nutrition programs, and case management.
• Provider Network Network of over 2,500 culturally competent healthcare providers including Primary Care physicians, specialists, behavioral health providers, pharmacies, and community-based organizations serving over 1 million Medicaid and Medicare beneficiaries.
• Value-Based Payment Model The only successful total cost of care Value-Based Payment model implemented by a physician-led group, rewarding providers for quality outcomes and cost reduction with capitated contracts.
• Care Management Holistic care management services addressing medical, behavioral, and social needs with community-based, culturally competent support delivered in patients' languages.
• Behavioral Health Services Mental health services including therapy, counseling, substance abuse treatment, and psychiatric care delivered in patients' languages and cultural contexts.
• Maternal Health Program Prenatal and postnatal care services supporting healthy pregnancies for women in underserved communities, addressing maternal health disparities.
• Food & Nutrition Services Nutrition counseling, food assistance programs, SNAP enrollment support, cooking classes, and meal delivery services to address food security for Medicaid members.
• Housing Assistance Housing support services including rental assistance, homelessness prevention, and assistance with housing improvements for patients with qualifying health conditions.
• Transportation Services Non-emergency medical transportation and transportation assistance to help patients access appointments and essential services.
• Children & Youth Services Healthcare services for children with chronic conditions, those in or exiting foster care, and juvenile justice involved youth.
• Special Needs Services Comprehensive care for individuals with Substance Use Disorder (SUD), Serious Mental Illness (SMI), or Intellectual and Developmental Disabilities (IDD).
• Justice Involved Reintegration Services Healthcare and reintegration support for individuals re-entering the community after justice system involvement, including physical and mental health care and resource connection.
• Medicaid Enrollment Assistance Certified Application Counselor (CAC) program helping Medicaid members maintain eligibility and navigate recertification processes.

Quantifiable outcome

• $35-48 million in annual savings with 90% quality score
• +5 more outcomes

Named customers4 records

Segments5 records

Ideal customer profiles3 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration7 records

Feature6 records

Partnerships

17 partnerships are on record, tiered core and secondary.

• New York State Department of HealthcoreStrategic or Co-development Partner · 1 January 2021SOMOS actively contributed to NY 1115 Waiver design, advocating for immigrant and safety-net communities. The waiver creates Social Care Networks (SCNs) and provides formal Medicaid coverage of health-related social needs (HRSN).
• Nino De La Caridad FoundationcoreStrategic or Co-development PartnerCommunity-based organization partner in the SOMOS Social Care Network governance structure, providing services to address health-related social needs.
• Catholic CharitiescoreStrategic or Co-development PartnerMonsignor Kevin Sullivan represents Catholic Charities in SOMOS SCN governance, contributing to social care services for underserved communities.
• RAIN (Regional Aid for the Needy)coreStrategic or Co-development PartnerAnderson Torres represents RAIN in SOMOS SCN governance, providing social services and housing assistance.
• ComunilifecoreStrategic or Co-development PartnerMarisa Greason represents Comunilife in SOMOS SCN governance, contributing to community-based health and social services.
• Dominican Medical Dental Community Outreach Society, Inc.coreStrategic or Co-development PartnerDr. Pedro Castillo represents this organization in SOMOS SCN governance.
• Providing for Children FoundationcoreStrategic or Co-development PartnerDr. Maria Molina represents this foundation in SOMOS SCN governance.
• Walks of Light (WOL Corp)coreStrategic or Co-development PartnerDr. Luisa Perez represents this organization in SOMOS SCN governance.
• Giving to the Children, Inc.coreStrategic or Co-development PartnerDr. Jorge Cornielle represents this organization in SOMOS SCN governance.
• Tremont Helps Inc.coreStrategic or Co-development PartnerNeal Polan represents Tremont Helps in SOMOS SCN governance.
• Pontifical Academy for LifesecondaryStrategic or Co-development PartnerPartnership to launch 'Thank you, Doctor!' awareness initiative promoting the family doctor-patient relationship as authority in health decision-making.
• Pierre Toussaint Scholarship FundsecondaryStrategic or Co-development PartnerPartnership providing Mental Health First Aid Training for college students.
• Managed Care Organizations (MCOs)coreStrategic or Co-development PartnerMedicaid managed care organizations partner with SOMOS SCN to provide enhanced services to enrolled members including housing, transportation, and nutrition assistance.
• NYC Health + HospitalssecondaryStrategic or Co-development PartnerCollaboration during COVID-19 pandemic on testing and vaccination efforts.
• President Biden's Administration / HHS Secretary Xavier BecerracoreStrategic or Co-development PartnerSecretary Becerra met with SOMOS leadership in February 2023 to discuss mental health access in underserved communities, validating SOMOS's model.
• NY State and City OfficialscoreStrategic or Co-development PartnerSOMOS physicians accompanied city and state officials in post-hurricane recovery missions to the Dominican Republic and Puerto Rico following Hurricane Fiona and Maria.
• NYU Langone HealthsecondaryStrategic or Co-development PartnerCollaboration on residency program for LGBTQ healthcare competency and Keith Haring Nurse Practitioner Fellowship (through partner organization Callen-Lorde).

Scale indicators16 records

Recent moves6 records

Expansion highlights5 records

Broad incumbents

• NYC Health + Hospitals: Municipal public hospital system serving predominantly Medicaid and uninsured populations across NYC; overlapping service population and SDOH mission with SOMOS' community-based model.
• CenterWell Senior Primary Care (Humana): Humana-owned value-based senior primary care network serving Medicare beneficiaries with complex chronic conditions under full-risk arrangements — broader scaled peer with similar population focus.
• Privia Health: National medical group and physician network enabling independent practices to transition to value-based care across multiple payor contracts; comparable as a scaled MSO/IPA platform with VBC orientation.

Regional players

• MetroPlusHealth: NYC-based not-for-profit Medicaid and Medicare managed care plan operated by NYC Health + Hospitals; directly comparable as a regional Medicaid payor serving the same attributed populations.
• Healthfirst: Not-for-profit NY-based Medicaid and Medicare managed care plan serving many of the same NYC communities as SOMOS; comparable as a Medicaid capitated payor in SOMOS' service area.

Direct peers

• VillageMD: Value-based primary care platform operating physician practices under risk-bearing arrangements with payors; comparable in its risk-bearing, physician-network model serving attributed lives through a multi-state footprint.
• Aledade: Physician-led ACO network enabling independent primary care practices to participate in value-based contracts across Medicare, Medicaid, and commercial payors — directly comparable IPA/MSO structure to SOMOS.
• Iora Health (One Medical): Primary care network built around full-risk relationships with Medicare Advantage plans and employer payors, emphasizing relationship-based care for diverse populations.
• ChenMed: Family-owned, physician-led VBC primary care group serving low-income, predominantly Medicare-eligible seniors through full-risk contracts — directly comparable model of culture-focused, capitated primary care.
• Oak Street Health: Physician-led value-based primary care network focused on Medicare beneficiaries in underserved communities, with full-risk capitation and integrated care management — operating the same VBC-for-underserved-populations playbook as SOMOS.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

• Xx.com/SOMOSCare

Revenue estimate

Valuation estimate

Number of profiles

Profiles24 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about SOMOS Community Care