In an agreement announced this spring, Lifespan Corp. now accepts Commonwealth Care Alliance health coverage, allowing CCA members access to all of the system’s providers.
Lifespan, the state’s largest health system, operates Rhode Island, Hasbro Children’s, The Miriam, Newport and Bradley hospitals, along with a range of specialty and primary care practices.
CCA, which expanded to Rhode Island in 2020, offers health care plans designed for people with complex medical needs or who may be vulnerable in other ways.
Dr. G. Alan Kurose, Lifespan’s senior vice president of primary care and population health and Coastal Medical president, and Corey McCarty, CCA’s Rhode Island general manager, offer perspective and details on the agreement.
PBN: What will the agreement between Lifespan and Commonwealth Care Alliance mean for CCA members?
MCCARTY: Our agreement will give CCA members in Rhode Island full access to Lifespan’s comprehensive system of hospitals, behavioral health services and primary care networks. Beyond that, though, our two organizations are hoping to complement one another in ways that will help us better understand and respond to gaps in the state’s health care system.
While we have been in regular contact with Lifespan’s leadership team since CCA first began exploring entering the Rhode Island market, our partnership is still relatively new. We are both looking forward to collaborating on a shared mission of improving health outcomes in Rhode Island’s traditionally underserved communities.
PBN: How does the agreement benefit Lifespan?
KUROSE: We added CCA to the insurance Lifespan accepts because we believe CCA shares our commitment to identifying innovative ways to provide outstanding community-based care. Their holistic approach to patients aligns with our priority to address disparities in social determinants of health and make care more accessible.
We are particularly supportive of their care model that addresses factors that impact health such as food insecurity, living conditions and lack of transportation. Lifespan’s partnership with CCA will provide more choice for our patients, particularly those with significant needs.
PBN: What sort of medical needs do CCA members often have?
MCCARTY: CCA has earned national recognition for our innovative model of care that improves quality and health outcomes while reducing the overall cost of care, and for our demonstrated success in improving care for individuals with significant health needs. Our mission is to identify these traditionally hard-to-reach individuals and provide them with the integrated care and supports they need to live safely and independently at home.
Many of our members are dually eligible for Medicare and Medicaid. These individuals qualify as high need based on their income or health status, and often live with multiple chronic conditions, physical or behavioral health disabilities, or severe mental illness.
In addition to their complex medical situations, the members we serve also have needs that fall outside the scope of traditional care delivery systems. These can be macro issues such as food or housing insecurity, or gaps that sometimes can be overlooked such as lack of reliable transportation, access to the internet, or temperature-controlled living environments.
Our on-the-ground, interdisciplinary care teams get to know our members on a personal level and connect them with community-based resources to efficiently manage their delivery of care, while filling existing gaps in their care.
PBN: Does this collaboration create any new pathways for either Lifespan or CCA to address disparities in health care?
KUROSE: Yes, the primary goal of our partnership is to combine our two organizations’ strengths to make high-quality, individualized care more accessible and more affordable for Rhode Islanders.
Across the country, the process of delivering high-quality care is rapidly changing. We’re evolving beyond simply treating a patient’s so-called “chief complaint,” and instead becoming a more proactive, more collaborative system that responds to the whole health needs of individuals and populations.
By working more closely with progressive payers like CCA, which has a proven track record in identifying their members’ core medical and nonmedical needs, we will be able to both better serve our patients’ day-to-day needs and implement best practices across our system that will improve health outcomes for all Rhode Islanders.
PBN: What health care options did CCA members have before this agreement was put in place?
MCCARTY: CCA has been active in Rhode Island since late 2020, building a network of clinical team members and administrative support personnel, while also meeting with leaders in Rhode Island’s public health sector. We officially entered the Rhode Island market this past January with a range of Medicare plans designed to support a holistic approach to care addressing both chronic conditions and multiple social or medical health needs.
CCA’s two Medicare Advantage Plans – CCA Medicare Preferred and CCA Medicare Value – are available to individuals who live in Rhode Island and are eligible for Medicare. CCA’s Dual Special Needs Plan – CCA Medicare Maximum – is available to Rhode Islanders who are eligible for both Medicare and Medicaid. We will have additional information on our available options when the annual enrollment period begins Oct. 15.
When CCA first entered the market in 2021, we were proud to offer our members a robust network of provider options, but it wasn’t until our agreement with Lifespan that we were able to add Coastal Medical to our network. Coastal Medical is consistently rated among the best-performing accountable care organizations in the nation, so CCA is thrilled that this critical offering is now part of our local network. Plus, as someone with a mother, father and grandmother who are patients of Coastal Medical, I take a great deal of personal pride in continuing to work with their team as we continue striving to deliver high-quality care to all Rhode Islanders.
Elizabeth Graham is a PBN contributing writer.
Want to share this story? Click Here to purchase a link that allows anyone to read it on any device whether or not they are a subscriber.