Coastal Medical, Lifespan and Blue Cross & Blue Shield of Rhode Island Collaborate on Shared-Savings Program

PROVIDENCE, R.I., March 2, 2016 /PRNewswire/ -- Blue Cross & Blue Shield of Rhode Island (BCBSRI), Lifespan, and Coastal Medical have entered into an innovative accountable care agreement aimed at improving the coordination of primary, specialty and inpatient care.  The agreement offers provider incentives that reward enhanced care management and more efficient delivery of care for the 45,000 BCBSRI members who receive their primary care from Coastal Medical providers.  This approach is expected to result in better health outcomes, lower costs, and better service to patients.

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Some of the early initiatives will include expansion of Coastal's existing condition-specific programs for patients with congestive heart failure, diabetes, and chronic obstructive pulmonary disease, and integration of those programs with existing systems of care at Lifespan. Shared work in the first year will also improve coordination of primary, specialty and inpatient hospital care as Lifespan and Coastal providers collaborate to create a more seamless experience of care specifically tailored to each patient's medical condition and personal preferences.

While each organization has been aggressively pursuing approaches in improving health outcomes and enhanced patient satisfaction, this agreement recognizes that further improvement in care delivery requires a more collaborative effort and a deeper partnership among key leaders in the state's delivery system. BCBSRI, Coastal, and Lifespan will remain fully independent under this agreement, but each will work with the others in a more aligned fashion than ever before.

Timothy J. Babineau, M. D., president and CEO of Lifespan, said the state's largest health system is committed to being on the forefront of creative and thoughtful care delivery. "Without question, the health care landscape is changing dramatically and for the better. The shift from volume-based to value-based care is critical to improving patient outcomes. We are all working together and learning a lot in the process," Babineau said.

 "Coastal Medical's primary care offices have been recognized nationally for their success in delivering high-quality care that emphasizes coordination of the services each patient receives beyond the walls of the primary care office" said Al Kurose, M.D., president and CEO of Coastal.  "Under this new agreement, Coastal and Lifespan and Blue Cross will be able to take care coordination to the next level and provide a more seamless experience of care for patients, especially those with complex needs."

"Whether they are facing complex health challenges or simply want to stay healthy, our members want the health care system to be simpler and more effective," said Peter Andruszkiewicz.  "The agreement with Coastal and Lifespan offers new incentives and support systems that will ensure we can guide our patients through the health system for easier access and better health outcomes.  Equally important, new financial incentives will continue our important work in making care affordable."

Patients covered by this agreement will also see expansion of Coastal's current evening and weekend hours for urgent primary care visits, streamlined processes for referrals to specialty care, and house-calls for a subset of patients with multiple chronic medical conditions and barriers to care.

About Lifespan

Lifespan (www.lifespan.org) is a five-partner not-for-profit health system based in Providence, R.I. Formed in 1994, Lifespan includes three teaching hospitals of The Warren Alpert Medical School of Brown University: Rhode Island Hospital and its Hasbro Children's Hospital; The Miriam Hospital; and Bradley Hospital, the nation's first psychiatric hospital for children. It also includes Newport Hospital, a community hospital offering a broad range of health services, and Gateway Healthcare, the state's largest provider of community behavioral health care.  Lifespan teaching hospitals are among the top recipients in the country of research funding from the National Institutes of Health. The hospitals received nearly $81 million in external research funding in fiscal 2012. All Lifespan-affiliated partners are charitable organizations that depend on support from the community to provide programs and services.

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 600,000 members. The company is an independent licensee of the Blue Cross and Blue Shield Association. For more information, visit www.bcbsri.com and follow us on Twitter @BCBSRI.

About Coastal Medical

Coastal Medical is a primary care driven Accountable Care Organization (ACO) delivering care to 120,000 patients, in 20 medical offices state-wide. Coastal is building the primary care office of the future by offering 365-day access to sick visits, developing chronic care management programs for its sickest patients, and building care teams that support not only their patients on a daily basis, but their primary care providers as well. Coastal also owns state-wide laboratories, an imaging center, and a medical billing company.

SOURCE Coastal Medical