Art Jones, MD, has 27 years of experience as a primary care physician and chief executive officer (CEO) at a Chicago area community health center. The health center has taken a population health approach from its beginning, addressing the social drivers of health, as well as the medical needs of the community it serves. Dr. Jones lived in this resource-challenged community for 34 years. The health center was an early adopter of managed care, successfully operating under a partial capitation payment system for all ambulatory and emergency room services and shared savings for inpatient services since the early 1990s. Starting with the Medicaid population, similar contractual arrangements were later extended to the Medicare and commercial populations. He was the architect for the first capitated federally qualified health center (FQHC) alternative payment methodology in the country in 2001. The health center earned recognition as a high performer under these advanced alternative payment models (APM), consistently scoring in the 99th percentile nationally when managed care margin with a uniformed data system metric.
Dr. Jones was one of the founders and continues to serve as the chief medical officer for Medical Home Network (MHN) accountable care organization comprised of thirteen FQHCs and three health systems serving 176,000 Chicago area Medicaid recipients. MHN is completely delegated for care management and is successfully operating under a shared risk arrangement for total cost of care. MHN supports 52 FQHCs in seven states in the CMS ACO REACH Program, serving approximately 50,000 Medicare insured individuals. His role at MHN includes assisting the CEO in proposing and negotiating advanced APMs with payers. MHN has generated $103 million in profits over their initial six years of operation. They outscore every Medicaid managed care organization in Illinois on the 21-metric quality score card composite.
Dr. Jones is a principal at HMA where he focuses on advancing clinically and financially integrated provider organizations. He helps them transition to outcomes-based payment and reap some of the downstream financial benefits from operating as a well-functioning patient-centered medical homes and integrated delivery systems. He is a sought-after national expert in creating FQHC APMs. He was part of the HMA team who worked with the State of Idaho Medicaid Agency to develop their shared savings program. He consulted with several other primary care associations, other FQHC integrated delivery systems, and individual FQHCs nationally to negotiate alternative payment methodologies with managed care health plans, including shared savings and to improve performance on those value-based payment arrangements. He worked with health systems and private physician independent practice associations to develop their value-based payment contracting strategy.
Dr. Jones is a graduate of the University of Illinois Medical School and completed his internal medicine residency, chief residency, and a cardiology fellowship at the University of Chicago.
