The North Country Initiative — or “NCI” for short — is a partnership of hospitals, independent physicians and community providers working together to reform the health care system across northern New York’s Jefferson, Lewis and St. Lawrence counties. With the healthcare system undergoing significant change at both state and national levels, we are working together to align incentives across our rural region, create clinical programs and develop necessary health technology infrastructure. We believe that cooperating on all of these strategies will improve the health of our community, reduce the cost of health care and improve care for patients. Much of our everyday work is grounded in working toward four key goals: 1. Improving the quality and efficiency of care for the rural, under-served population 2. Providing accessible, effective, high-quality health care 3. Aligning health system partners with payers to drive clinical improvement and add value to patients 4. Implementing evidence-based medicine to enhance patient outcomes