PROVIDENCE, R.I. (AP) — Providence-based Lifespan and UnitedHealthcare hope a new partnership announced Wednesday will close gaps in what they call a fragmented health care system — while improving patient health and lowering costs.
Officials said Lifespan is one of only a handful of organizations across the U.S. — and the first in Rhode Island — to participate in UnitedHealthcare's "shared savings" program. The effort emphasizes collaborative care and a payment system based more on how patients are doing than the volume of procedures or tests a doctor or lab performs.
Under a three-year contract that begins in July, it is expected to provide care for about 21,000 people in the state who are enrolled in UnitedHealthcare's employer-sponsored health plans, officials said.
"We think the two partners are uniquely positioned to do some things that are new and innovative," said Dr. Timothy Babineau, president and chief executive officer of Lifespan, whose health system includes Rhode Island Hospital and its Hasbro Children's Hospital, The Miriam Hospital, Newport Hospital and Bradley Hospital. "That's really how we're going to get at this issue of a health care system whose costs are increasing at an unsustainable rate."
Added Stephen Farrell, CEO of UnitedHealthcare of New England: "This gives an opportunity to work together, which is kind of unique. We haven't always been on the same side."
Lifespan, which is affiliated with Brown University's School of Medicine, and UnitedHealthcare call the partnership an "accountable coordinated care organization," a variation on the "accountable care organization" model provided for in President Barack Obama's signature health care overhaul, the Affordable Care Act.
The idea behind the ACO program, which is administered by the federal Centers for Medicare and Medicaid Services, is to increase communication and coordination among health providers of all types — from primary care doctors and hospitals to long-term care facilities — to boost the quality of care for Medicare patients. If the organizations save money while meeting a long list of standards, they share in the savings with Medicare.
Babineau called the Lifespan-United partnership a "next-generation" ACO and said it should help address fragmented care — where patients are handed off from doctor to doctor, or hospital to hospital — and improve sometimes "dysfunctional" communication.
Neither Lifespan nor United offered an estimate for how much savings the partnership might produce.
"If we can quantify savings, we want to share those savings with Lifespan so they can invest it back into their infrastructure redesign to continue this work," said Farrell.
Babineau said Lifespan is still working out how any savings would be shared among physicians and the health system.
"This is going to be a learning experience," he said. "On Day One we're not going to have all the answers, but we're going to approach the problem in a new way."