Policy & Value-Based Care

Integra, UnitedHealthcare Launch Medicaid ACO in Rhode Island

April 19, 2016

Integra Community Care Network, a Centers for Medicare & Medicaid Services (CMS)-certified Accountable Care Organization (ACO) is partnering with UnitedHealthcare Community Plan of Rhode Island to launch a Medicaid ACO entity.

Heather Landi

As part of the joint effort, UnitedHealthcare is collaborating with physician groups as part of the State of Rhode Island Accountable Entities Pilot.

The initiative marks the first Medicaid accountable care entity launched in Rhode Island and the goal is to improve health outcomes for UnitedHealthcare Medicaid enrollees, increase patient satisfaction and reduce the overall cost of care. The initiative is part of the state’s Reinventing Medicaid Act of 2015, which aims to transform Rhode Island's Medicaid program and achieve tens of millions of dollars in savings each year without cutting Medicaid eligibility or reducing benefits.

Integra and UnitedHealthcare will work together to better coordinate patients’ care, using shared technology and information about emergency room visits and hospital admissions, and services that help patients manage their chronic health conditions and encourage healthy lifestyles, according to a press release.

The Integra care provider network is composed of the Care New England and South County Health systems, Rhode Island Primary Care—the state’s largest primary care organization—and a number of independently employed and community physicians.

“The goal of an accountable entity is to improve the health and health care of the people we serve. We believe that the state’s patient-centered medical home initiatives established a strong foundation for this approach. UnitedHealthcare has been a long-time supporter of the value primary care providers can bring to coordinating care and thereby better controlling costs,” James Fanale, M.D., chief clinical integration officer of Care New England, and chief clinical officer, Integra Community Care Network, LLC, said.

“From the start, our work to Reinvent Medicaid was driven by the goal to expand access to care, improve quality and coordination, and lower costs for taxpayers,” Rhode Island Gov. Gina Raimondo, said in a statement. “Accountable entities like this will reward collaboration and help spark transformation throughout Medicaid.”