PROVIDENCE — The Integra Community Care Network reported an $8.3 million savings in 2016 under the Medicare Shared Savings Program with a simultaneous 95 percent quality score Thursday, continuing a trend begun in 2015, the organization’s first year as an Accountable Care Organization.
The Integra Community Care Network includes Rhode Island Primary Care Physicians Corp., Care New England and South County Hospital, and employed and affiliated physicians.
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For calendar year 2015, Integra realized savings of nearly $4 million on total health care spending of slightly more than $152 million, according to a Care New England statement. 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.
Medicare ACOs are groups of doctors, hospitals, and health care providers voluntarily providing coordinated 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.
In January 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.
Integra is the largest Accountable Care Organization in Rhode Island, covering about 120,000 people, with a network of more than 225 primary care providers and more than 430 specialists.
“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 Dr. Al Puerini, chairman of Integra’s board of directors.
About $3.85 million will be shared with the primary care practices and reinvested to ensure Integra continues to build on this accomplishment, the company reported.
“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 D. 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 health care. Today’s announcement highlights the benefits of preventive care, reducing unnecessary hospitalizations, and active care management that helps patients live healthier lives.”
“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.”
Rob Borkowski is a PBN staff writer. Email him at Borkowski@PBN.com.
