Total Medicare savings for 2016 exceed $8.3 million for Rhode Island’s largest accountable care organization
Providence, RI: The Centers for Medicare & Medicaid Services (CMS) has released the 2016 performance year results for the Medicare Shared Savings Program showing that the Integra Community Care Network realized $8.3 million in savings under the Medicare Shared Savings Program while achieving a 95% quality score. The Integra Community Care Network includes Rhode Island Primary Care Physicians Corporation (RIPCPC), Care New England and South County Hospital and employed and affiliated physicians.
“These results show the accountable care model is here to stay and that Integra delivered exactly what we promised: comprehensive care coordination that unites primary care, specialists, care managers, and skilled nursing facilities,” said Al Puerini, MD, chairman of Integra’s board of directors.
As a result of this achievement, a portion of the savings ($3.85 million) will be shared with the primary care practices and reinvested to ensure Integra continues to build on this accomplishment.
“Three years ago, Care New England, Rhode Island Primary Care Physician Corporation, South County Hospital, and community physicians across the state formed Integra with the goal of improving the quality of care, achieving better health for our beneficiaries, and decreasing health care costs, and that’s exactly what we’ve done,” said Dennis Keefe, president and CEO of Care New England. “Care New England is invested in and committed to population health because that is the future of healthcare. Today’s announcement highlights the benefits of preventive care, reducing unnecessary hospitalizations, and active care management that helps patients live healthier lives.”
Integra is the largest Accountable Care Organization in Rhode Island, covering approximately 120,000 lives, with a provider network of more than 225 primary care providers and more than 430 specialists.
“This performance in quality and efficiency is the result of the teamwork and dedication of Integra’s providers, staff, and leadership,” said James E. Fanale, MD, Integra’s chief clinical officer. “By providing the right care, at the right time, in the right place we’re reducing unnecessary admissions and readmissions, reducing visits to the ED, length of stay is down, skilled nursing facility utilization is down, and quality scores have improved. These outcomes are the core of what population health is all about.”
This year’s results continue the progress begun in 2015. For calendar year 2015, Integra’s first year operating as a Medicare ACO, Integra realized savings of nearly $4 million on total health care spending of slightly more than $152 million. In its first year of operation Integra also saw significant improvement on most quality measures, scoring at or above the national mean in most areas, and scoring higher than the national average in 22 out of the 34 measures. “The collaboration necessary to make this effort a success is unprecedented,” said Louis R. Giancola, president and CEO of South County Health. “It’s a win for payers, providers, and most importantly patients. This model works and is only going to get better moving forward.”
“The role of primary care providers is crucial to the success of the new model of health care,” said Noah Benedict, COO for RIPCPC. “Better information and increased care coordination allows our primary care physicians to provide the highest-quality of care to their patients and families in a cost-effective manner.”
Medicare ACOs are groups of doctors, hospitals, and other health care providers, who come together voluntarily to provide coordinated high quality care to their Medicare patients. The goal of coordinated care is to ensure that patients, especially the chronically ill, get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors. When an ACO exceeds quality and financial thresholds – demonstrating achievement of high-quality care and wiser spending of health care dollars – it is able to share in the savings generated for Medicare.
The results reported today were realized under the Medicare Shared Savings Program. Effective January 1, 2017 Integra began participating in the Next Generation Accountable Care Organization Model, assuming higher levels of financial risk and reward than were available under the previous model.Additional Resources
Integra Community Care Network is a CMS certified ACO with more than 120,000 covered lives. Its participating provider network includes Rhode Island Primary Care Physicians Corporation (RIPCPC), Care New England and South County Hospital and employed and affiliated physicians. Integra was also named as an Accountable Entity by the RI Executive Office of HHS and assumed responsibility for more than 30,000 Rite Care participants, effective January 1, 2016.