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ARTICLE Coastal Physicians and UnitedHealthcare Launch Accountable Care Organization in Rhode Island


PROVIDENCE, R.I. (March 26, 2013) – Coastal Medical and UnitedHealthcare are launching an accountable care organization (ACO) in Rhode Island, enabling primary care doctors to more easily manage all aspects of a patient's health care and to facilitate a proper course of treatment.

 

Coastal Medical is a leading primary care group practice and medical management company with more than 100 care providers practicing in 19 locations throughout Rhode Island. Coastal Medical's offices are recognized as National Committee for Quality Assurance (NCQA) Level 3 Patient Centered Medical Homes (PCMH).

 

UnitedHealthcare, a UnitedHealth Group (NYSE: UNH) company, serves nearly 250,000 Rhode Island residents with a care provider network of 13 hospitals and more than 2,500 physicians statewide. The new ACO will help Coastal Medical physicians improve transitions of care for their patients and facilitate better communication with other medical providers involved in a patient's treatment. The ACO will be made available to all Rhode Island residents enrolled in UnitedHealthcare's employer-sponsored health plans.

 

Coastal Medical and UnitedHealthcare are helping shift Rhode Island's health care system to one that rewards quality and value of care vs. volume of patients treated by creating this ACO.

 

This is the latest in a series of programs UnitedHealthcare has created to improve the quality and efficiency of health care in line with the Institute for Healthcare Improvement's "Triple Aim" – increase patient satisfaction, improve people's health and reduce health care costs.

 

"Coastal Medical looks forward to working with UnitedHealthcare to enhance the quality and efficiency of health care for thousands of Rhode Islanders. We are committed to promoting better health, delivering better care, lowering overall costs, and improving the patient experience of care," said G. Alan Kurose, M.D., president of Coastal Medical.

 

"Coastal Medical is recognized as a leader in innovative clinical initiatives that improve quality, simplify care and reduce costs. The new ACO will provide access to this model of care for nearly 190,000 of our health plan customers in Rhode Island," said Stephen J. Farrell, CEO, UnitedHealthcare Employer & Individual of New England.

 

UnitedHealthcare plan participants who currently receive care from Coastal Medical care providers do not have to do anything differently to receive the benefits of the ACO, which include enhanced care coordination and follow-up. Primary care physicians in the ACO will receive monthly updates on their patients, enabling them to monitor all of the care each patient is receiving, and to maintain all clinical information about each patient in a single electronic medical record.

 

For example, if a patient is being treated for heart disease, all the tests, screenings and medications the patient is receiving will be collected into one record to ensure that the appropriate course of care is being followed, the care is coordinated among all providers, and the patient is receiving any and all necessary services. This model will help manage services for patients with chronic conditions, such as diabetes and heart disease, while keeping the focus on health and well-being for people who are not ill.

 

Coastal Medical care providers will be eligible for payment incentives based on meaningful improvements in measures such as readmission rates, disease management and prevention, patient safety, and care delivery that is well supported by science.

 

UnitedHealthcare is working with thousands of physician groups, hospitals and medical centers, and other health care providers nationwide to place greater emphasis on rewarding care providers for better care, better health and lower costs. Today, more than $20 billion of UnitedHealthcare's annual physician and hospital reimbursements is tied to accountable care programs, centers of excellence and other performance-based programs.

 

About Coastal Medical
Coastal Medical is Rhode Island's first Medicare Shared Savings ACO as well as the state's largest physician owned and physician governed primary care group practice. Coastal provides predominantly primary care, along with some specialty services, to 105,000 patients in 19 medical offices across Rhode Island. Coastal also owns state-wide laboratories, an imaging center and a medical billing company that provides services to physician practices and hospital owned medical practices across the country.

 

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 and Medicare and Medicaid beneficiaries, and contracts directly with 780,000 physicians and other health care professionals and 5,900 hospitals and other care facilities nationwide. UnitedHealthcare serves more than 40 million people in health benefits and is one of the businesses of UnitedHealth Group (NYSE: UNH), a diversified Fortune 50 health and well-being company.