insurance

Blue Cross, University sign 3-year contract

Posted 7/22/13

PROVIDENCE – In what promises to be a forerunner of a new, networked health insurance product to be offered to Rhode Island customers beginning in January 2015, Blue Cross & Blue Shield of Rhode Island and University Medicine signed a three-year, shared-savings contract.

The new partnership between Blue Cross, the state’s largest health insurer, and University Medicine, the state’s largest multi-specialty group with about 200 physicians, seeks to improve the metrics on quality care and patient safety while slowing increases in medical utilization costs, according to Blue Cross spokeswoman Stacy Paterno.

Currently, Blue Cross has two shared savings contracts in place with medical groups, University and Coastal Medical Group.

In the patient-centered medical homes in Rhode Island it supports, there are 4,710 providers, 370 physicians and 132,000 patients, according to Paterno.

HealthSourceRI, the state’s health benefits exchange, will begin negotiating in October of this year with health insurers on the details of the new tiered, networked health insurance products to be offered beginning Jan. 1, 2015, according to Christine Ferguson, the executive director of HealthSourceRI.

In the new, shared-savings contract announced on July 17, University Medicine will focus on improving patient experience, limited unnecessary hospitalizations, and reinforcing the role of primary care physicians. To do this, the medical group will be expanding its hours on weekends and evening, employing a health advocate to help patients navigate the delivery system, better integrate of behavioral health services with primary care, and expand its six current patient-centered medical homes to include specialists.

“University Medicine has a unique opportunity to make a significant impact for their patients and our members, and we are truly excited about the work we are doing with them,” said Peter Andruszkiewicz, president and CEO at Blue Cross. “By partnering with organizations like University Medicine, real change is possible.”

“University Medicine is taking its commitment to primary care and bringing our specialists into the patient centered medical home,” said Dr. Lou Rice, president of University Medicine.

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