Why Cityblock Health Believes It Can Break A Mold That Home Health Agencies Can’t

It may be an overused quote at this point, but it’s one Kameron Matthews can’t help but come back to when thinking about the health care system in the U.S.

The definition of insanity, Albert Einstein once famously said, is doing the same thing over and over and expecting different results.

“Most home health agencies that you talk to, they’re not imagining a system outside of their current financial structure because they need to keep their doors open,” Matthews, the chief health officer for Cityblock Health, told Home Health Care News. “They’re a little less, understandably, comfortable stepping outside of the box and thinking transformationally.”


Cityblock Health, a provider startup focused on marginalized populations with complex needs, is trying to do just that.

Although Cityblock may not be the first and only provider to think differently about episodic care and value-based payment models, the company is making noise in the home-based care space and wants to keep growing.

“In primary care, as a field, we can say we take care of the whole patient, but when it comes down to it — unfortunately — activity tends to really mirror the financial model,” Matthews said. “Our founders really focused on how to take care of the whole patient, not just episodically. Cityblock is purposefully, one: seeking to be part of transformational primary care. And two: purposefully looking to address the health inequities that communities in low-income environments experience, particularly in Black and Brown communities.”


Cityblock Health delivers medical care, behavioral health and social services to individuals from historically underserved and marginalized communities in six markets: New York, Massachusetts, Washington, D.C., North Carolina, Ohio, and Indiana.

In September, Cityblock teamed up with MDwise, the second-largest Medicaid managed care organization in Indiana. Partnerships like the one with MDwise reflect Cityblock’s mission to address health inequity.

“We are purposefully partnering with entities that are working with patients who are on Medicaid or dual-eligible beneficiaries,” Matthews said. “We’re reaching communities that typically don’t, unfortunately, receive these services. All with a value-based care model in mind, so that we have accountability and responsibility for our members. Our incentives are aligned to really achieve high-quality outcomes, whether that be clinical or financial.”

Cityblock is trying to create a one-stop shop when it comes to in-home primary care. The evidence has shown that having multiple services under one roof can improve outcomes and eventually lower costs, Matthews said.

“We need to make sure that we’re providing the best clinical care possible,” Matthews said. “Time and time again, the evidence shows that it is through continuity of care in a primary care model and offering a one-stop shop. Transforming finances, taking care of the whole patient and doing so for patients who are neglected by the rest of the system: That’s the Cityblock model.”

Cityblock recognizes the importance of partnerships across the care spectrum and does plan on partnering with more home health agencies in the future.

Matthews believes as more agencies warm up to the idea of value-based care, more partnerships will start to form.

“I would absolutely love to explore those types of dynamics,” she said. “There’s absolutely no point in us recreating wheels. We recognize that our model is about pulling pieces together to do things in a different manner. It doesn’t mean we need to recreate different services or build things ourselves. We’re always looking for potential partnerships.”

Continued growth in the next two to three years is a top priority for the startup. But challenges persist with scaling the Cityblock model across state lines, where regulations and legislation differ.

Beyond growth, Matthews is keeping a close eye on the Medicaid redetermination that will be lifted in April.

“I’m very nervous about that. That keeps me up at night,” Matthews said. “For the past couple of years, we’ve had the buffer for our Medicaid beneficiaries across the country. There’s been some stability there and it’s been completely necessary, obviously, in reaction to the pandemic. When you’re thinking about the continuity of care, keeping these patients engaged and trusting the health care system enough to actually participate — when they get dropped from the rolls on an annual basis, that’s troublesome.”

That process is an example of how the federal health care system does not always prioritize patients’ care in a fashion that actually benefits them, Matthews said. Especially when it comes to the people Cityblock is trying to reach.

Long-term, Matthews is excited about the continued visibility on health equity and Cityblock’s role in that fight.

“I am keeping my fingers crossed that there’s a continued focus and priority for the next year on health equity,” Matthews said. “That it’s not just because there was visibility during the pandemic and not just because there are conversations of racial injustice from a political tone, but that we recognize that a health care system where some are being treated inequitably means that the entire system itself has problems that need to be solved.”

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