BCBSRI, Chicago-based Oak Street Health plan 3 R.I. Medicare primary care centers

This article has been edited to reflect a more accurate estimate of Oak Street's initial employee count in Rhode Island.

BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND and Oak Street Health will open three primary care health centers for Medicare patients in Rhode Island in 2019. Above, a view of an Oak Street Health center's front desk in Ashburn, Ill. / COURTESY TORI SOPER
BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND and Oak Street Health will open three primary care health centers for Medicare patients in Rhode Island in 2019. Above, a view of an Oak Street Health center's front desk in Ashburn, Ill. / COURTESY TORI SOPER

PROVIDENCE — Blue Cross & Blue Shield of Rhode Island is partnering with Chicago-based Oak Street Health, a network of primary care centers serving Medicare patients, to open three facilities serving unmet demand in Rhode Island in 2019.

Oak Street Health will open two centers in Providence and a third in Warwick in spring 2019, each of which will be able to care for about 4,000 people, said BCBSRI spokesperson Gail Carvelli.

Those people will be exclusively from BCBSRI’s 55,000 Medicare advantage customers, and traditional (fee-for-service) Medicare members said Dr. Gus Manocchia, chief medical officer at BCBSRI. Over time, he said, Oak Street Health will expand to partnerships with other payers.

He said the partnership helps BCBSRI meet a shortage of access to care their customers have complained about.

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“We have heard numerous complaints from members,” about their ability to access primary care, he said.

BCBSRI analyzed healthcare quality and patient experience survey data from recent years, identifying gaps in our state’s healthcare delivery ecosystem, said Gail Carvelli, managing director, public relations at BCBSRI. The company decided to find a partner to improve care for the Medicare population, and found a solution with Oak Street Health.

Manocchia said the centers Oak Street operates tend to weave into the fabric of their host communities. He said he visited the company’s center in Chicago and was impressed with the community-centered activities available including fitness and educational classes.

“There was no other building in that community that served that purpose,” Manocchia said of his visit to Oak Street’s center.

“Blue Cross was looking for a partner,” said Mike Pykosz, CEO of Oak Street. “We got very excited very quickly about the opportunity.”

Pykosz said Oak Street’s interest in Rhode Island has to do in part with the large number of Medicare patients in the state – there is 13.9 percent of the State’s population 65 and older, ranking it 8th in the nation for the population, according to the R.I. Department of Elderly Affairs.

But also, he said, “The community can really benefit from what we do.”

Oak Street’s care model is designed to meet the health and wellness needs of older adults with Medicare coverage, according to the company. Physicians and a dedicated care team spend twice as much time with patients compared to the typical primary care provider, according to the company.

Each Oak Street Health center also offers services to help patients understand their insurance benefits and hundreds of community-centered activities such as fitness, educational classes and entertainment that help address growing issues like loneliness and isolation.

For patients who require medical attention at home, Oak Street Health’s complex care teams provide much-needed medical attention until patients are able to return to their local center. Complimentary door-to-door transportation – via the company’s green-colored minivans – eliminates worry about getting to and from appointments. Oak Street Health also staffs a support phone line 24-7.  The model, according to BCBSRI, has allowed Oak Street Health to reduced hospital admissions and emergency visits among its patient population by more than 40 percent.

“We increase the quality of care and lower costs at the same time,” Pykosz said.

Oak Street tends to focus on the clinically ill Medicare population, and those with low income, Manocchia said.

Manocchia said the vast majority of BCBSRI’s Medicare customers already have a relationship with a primary care doctor, who will have the option to receive care with Oak Street. Pykosz said the majority of Oak Street’s customers in a given market come from existing Medicare customers, who are swayed by both the quality of primary care they offer and the services, which are paid for by the savings realized in savings from better care.

“Many of our members already have relationships with their PCP and may not want to switch. So it’s hard for us to say what the demand will be like when the centers open. We do know that there is a primary care access issue in Rhode Island and are hopeful this will help provide more access,” said Carvelli.

Manocchia said the patients who patronize Oak Street’s centers will still need hospital visits and specialist visits.

The sites will collectively employ about 100 employees, which they expect to grow, Pykosz said. He said the sites, at 712 Broad Street, Providence; 650 Branch Ave., Providence; and at 300 Quaker Lane, Warwick, will be remodels of existing buildings.

Oak Street Health currently employs more than 1,300 people, across more than 40 centers, most of whom live near the center at which they work.

“Our patients can count on friendly and recognizable faces at each center; we’re committed to making each center a cornerstone of its local community, and we’re purposeful in meeting our patients’ cultural needs and speaking their native languages,” Pykosz said. “In all of our markets, we’re dedicated to investing in, and hiring from, the local community. We anticipate adding a substantial amount of new jobs in Rhode Island in the next several years.”

Rob Borkowski is a PBN staff writer. Email him at Borkowski@PBN.com.