RI's Coastal, UnitedHealthcare offer new model

RI's largest primary care practice and UnitedHealthcare offering new health care model

PROVIDENCE, R.I. (AP) -- Rhode Island's largest medical practice of primary care doctors is joining UnitedHealthcare in an effort to provide better coordinated and less costly health care, the two companies announced Tuesday.

Executives at Coastal Medical and UnitedHealthcare said the so-called "accountable care organization" will help doctors more easily manage care and coordinate with a range of health providers.

The shared-savings arrangement — under a two-year contract that begins April 1 — provides financial incentives to doctors who improve care and meet certain goals in various areas including disease prevention, patient safety and hospital readmission rates.

The model, introduced as part of the federal health care overhaul known as the Affordable Care Act, aims to emphasize quality of care over patient volume.

Dr. G. Alan Kurose, president of Coastal Medical, which has 19 medical offices across the state, said in an interview that the arrangement with UnitedHealthcare is about trying to transform both the way health care is delivered and how it is paid for.

"The number of (patient) visits you perform each day really should not be the measure, or the sole measure, of how you're compensated," he said. "We need to be accountable for quality measures."

But he added: "If you want to drive system reform, you have to put some incentives out there to drive it."

The new organization will attempt to make a patient's transition from one health provider to another more seamless, starting with the primary care doctor. Coastal doctors, for instance, will get monthly updates on their patients that show all the care the patients are receiving. All clinical information, from screenings to medications, will be kept in a single electronic medical record.

About 10,000 Coastal patients with UnitedHealthcare coverage are initially expected to receive care under the new model.

Neither company would estimate how much savings might be realized.

"We're very interested in the 'triple aim' of better quality, lower costs and a better patient experience, and we think this agreement between us and Coastal helps get us there," said Stephen Farrell, CEO of UnitedHealthcare of New England.

Last year, Coastal, which has 105,000 patients, became the first organization in Rhode Island to participate in the accountable care organization program for Medicare recipients. UnitedHealthcare last month announced a similar shared-savings program with Lifespan, the state's largest health system. It begins in July.