CharterCARE and UnitedHealthcare to Improve Medicaid Patients' Health and Health Care in Rhode
Island
- Accountable care collaboration to enhance how the health system cares for
patients
- More resources committed to sharing information and coordinating patient care
CharterCARE Health Partners, CharterCARE Provider Group RI, LLC, and UnitedHealthcare Community Plan of Rhode Island have
launched a Medicaid accountable care program to improve health outcomes, increase patient satisfaction and reduce the overall cost
of care for people enrolled in UnitedHealthcare Medicaid plans.
UnitedHealthcare is collaborating with physician groups as part of the State of Rhode Island Accountable Entities Pilot to
improve coordination of care for people enrolled in Medicaid. Approximately 5,000 people enrolled in UnitedHealthcare’s Medicaid
health plans in Rhode Island will benefit from this collaboration with CharterCARE.
The Reinventing Medicaid Act of 2015 is a comprehensive, progressive package of reforms that positions Rhode Island to improve
access to high-quality care and achieve more than $100 million in annual Medicaid savings without cutting Medicaid eligibility or
reducing benefits, according to the state.
“From day one, the top priority in our work to transform Medicaid has been to provide Rhode Islanders with better care and
achieve healthier outcomes for more people,” said Rhode Island Gov. Gina M. Raimondo. “Accountable entities like these will reward
collaboration and help shift our entire health care system toward a structure that pays for outcomes and quality, rather than
volume of services. I commend CharterCARE and UnitedHealthcare for leading the way in this effort.”
UnitedHealthcare, the CharterCARE system and CharterCARE Provider Group RI will work together to better coordinate patient care
by using shared technology and information about emergency room visits and hospital admissions, and services that help patients
manage their chronic health conditions and encourage healthy lifestyles. The accountable care program also changes the incentives
so that care providers have a shared responsibility for the overall cost of care, moving away from a system that reimburses for
quantity of services provided to one that rewards the quality of patients’ health outcomes and has the potential to reduce overall
costs.
“Through this accountable care collaboration with UnitedHealthcare, we are well positioned to increase services and offer more
enhanced patient care for Medicaid enrollees,” said John J. Holiver, FACHE, CEO of CharterCARE. “This new relationship will enable
us to start applying our innovative Prospect Coordinated Regional Care model to improve health outcomes, increase patient
satisfaction and reduce the overall cost of care for people enrolled in Medicaid.”
UnitedHealthcare will support overall population health, giving the entire care team clear, actionable data about individual
patients’ health needs, potential gaps in care and proactive identification of high-risk patients. Community-based health workers
and care managers will support community-based care coordination, such as helping with planning after a patient is discharged from
the hospital and scheduling follow-up appointments.
“We look forward to working with the CharterCARE system and CharterCARE Provider Group RI to enable people to receive more
personalized and better coordinated care, which will significantly enhance their ability to live healthier lives,” said Patrice
Cooper, CEO of UnitedHealthcare Community Plan of Rhode Island.
UnitedHealthcare serves nearly 300,000 Rhode Islanders with a network of 15 hospitals and more than 4,500 physicians and other
care providers statewide.
Nearly 15 million people enrolled in UnitedHealthcare plans across the country have access to accountable care programs,
delivered in part through more than 800 accountable care arrangements nationwide as the organization engages in deeper, more
collaborative relationships with physicians and hospitals.
Care providers nationwide are showing strong interest in a shift to value-based care. UnitedHealthcare’s total payments to
physicians and hospitals that are tied to value-based arrangements have tripled in the last three years to more than $52 billion.
By the end of 2018, UnitedHealthcare expects that figure to reach $65 billion.
For more information about UnitedHealthcare’s full spectrum of value-based initiatives, visit www.UHC.com/valuebasedcare.
About CharterCARE Health Partners
CharterCARE Health Partners is a coordinated regional care network comprised of two acute care hospitals, a large nursing home
facility, a regional cancer center, a rehabilitation center, a community primary care center and a home health services company.
CharterCARE also operates a school of nursing. CharterCARE Provider Group RI, LLC is large independent practice association (IPA)
with more than 500 providers closely aligned with the CharterCARE system. Our coordinated regional care model allows us to deliver
services to patients at multiple levels of care, at the right time and place and at lower costs. This way of organizing and
delivering health care services enables us to optimize population health management strategies in Rhode Island. CharterCARE is a
joint venture company that leverages both the health care management expertise and capital strength of Prospect Medical Holdings,
Inc., a California-based company that owns and operates hospitals in Texas, California, Pennsylvania and New Jersey.
About UnitedHealthcare
UnitedHealthcare is dedicated to helping people nationwide live healthier lives by simplifying the health care experience, meeting
consumer health and wellness needs, and sustaining trusted relationships with care providers. The company offers the full spectrum
of health benefit programs for individuals, employers, military service members, retirees and their families, and Medicare and
Medicaid beneficiaries, and contracts directly with more than 1 million physicians and care professionals, and 6,000 hospitals and
other care facilities nationwide. UnitedHealthcare is one of the businesses of UnitedHealth Group (NYSE: UNH), a diversified
Fortune 50 health and well-being company. For more information, visit UnitedHealthcare at www.uhc.com or follow @myUHC on Twitter.
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UnitedHealthcare
Maria Gordon Shydlo, 914-933-4613
maria_g_shydlo@uhc.com
or
CharterCARE
Otis Brown, 401-456-3070
obrown@chartercare.org
or
State of Rhode Island
Sophie O’Connell, 401-275-3837
sophie.oconnell@ohhs.ri.gov
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