Care New England (CNE), RI Primary Care Physicians Corporation (RIPCPC), and Blue Cross & Blue Shield of Rhode Island (BCBSRI) announced today the state’s first accountable care payment model. This new agreement will include more than 10,000 BCBSRI Medicare Advantage members. By moving away from the traditional fee-for-service model, the agreement includes innovative features designed to improve quality and outcomes, enhance coordination of care and ultimately drive down costs for patients.
Under the terms of the three-year agreement, the three parties will share savings and risk, providing significant new incentives to improve coordination and communication across all aspects of patient care. The agreement builds upon BCBSRI’s and CNE’s August 2013 agreement to create a partnership that will further improve healthcare delivery and patient care, and also advances the shared “Triple Aim” goals of improving patients’ experience, improving overall population health, and reducing the cost of health care.
“This groundbreaking collaboration is a prime example of the kind of partnerships we need to truly transform healthcare here in Rhode Island – it takes trust, shared accountability and a willingness to truly change the existing broken system.” said Peter Andruszkiewicz, President and CEO, BCBSRI. “We’re tremendously proud of this partnership with Care New England and RI Primary Care, and hope it encourages others to do more and move even more quickly to improve the health of our communities.”
“The key to improving healthcare is cooperation and collaboration among all the parties that provide different levels of care to our patients. The deficit in our system has been the lack of effective communication between PCPs, hospital personnel, specialists and payers,” said Al Puerini, President, RIPCPC. “This joint initiative, for the first time in RI, brings together ALL involved parties to work together and provide the best possible approach across the healthcare spectrum, while keeping the patient firmly in the center of the total care initiative. We, at RIPCPC, are extremely excited about working with our partners to advance and improve healthcare delivery for Rhode Islanders.”
The physician-led partnership, which includes more than 100 of RIPCPC’s providers as well as all of Care New England’s four hospitals and VNA of CNE, incorporates national and industry quality measures with a focus on patient care and outcomes.
“As this agreement illustrates, true payment and care transformation can only take place when all of the parties – the insurer, the physicians, the hospitals, home health and other providers – are engaged in the solution,” said Dennis Keefe, president and CEO, CNE. We are excited to be collaborating with such forward-thinking partners who share our vision of what will benefit the patient community.”
The agreement was effective January 1, 2014, and will cover more than 10,000 BCBSRI Medicare Advantage members. In addition to RIPCPC, it includes Care New England’s Kent Hospital, Memorial Hospital, Women & Infants Hospital, Butler Hospital, Kent Physician Hospital Organization (PHO), Memorial PHO, Women & Infants PHO, and VNA of Care New England. Sixty percent of the providers included in the agreement are Patient-Centered Medical Home (PCMH) practices.
About Blue Cross & Blue Shield of Rhode Island
Blue Cross & Blue Shield of Rhode Island is the state’s leading health insurer and covers more than 450,000 members. The company is an independent licensee of the Blue Cross and Blue Shield Association. For more information, visit www.bcbsri.com, follow us on Twitter @BCBSRI, and like us on Facebook at fb.com/bcbsrhodeisland.
About Care New England
Care New England, located in Rhode Island, was founded in 1996 by Butler Hospital, Kent Hospital and Women & Infants Hospital. Memorial Hospital of Rhode Island joined the system as a hospital partner in 2013. Care New England is an integrated health care system that offers a continuum of quality care. The system includes primary care and specialty physicians; three teaching hospitals affiliated with The Warren Alpert Medical School of Brown University, Butler, Memorial and Women & Infants; a community hospital, Kent; a visiting nurse and home care agency, the VNA of Care New England; and Care New England Wellness Center. For more information, visit carenewengland.org.
About Rhode Island Primary Care Physician Corporation
Rhode Island Primary Care Physicians Corporation is an independent practice association (IPA) of primary care physicians located throughout the state of Rhode Island. The IPA, originally formed in 1994, represents 150 physicians from Family Practice, Internal Medicine, and Pediatrics, caring for more than 220,000 Rhode Islanders. Its mission has always been to improve patient care, promote wellness and enhance the patient-physician relationship.