health care

Championing a new business model for health care

Posted 7/30/12

CRANSTON – A new, disruptive business model, called “Living RIte – A disruptive solution for management of chronic care disease,” was awarded $14 million in a three-year Innovation grant by the Centers for Medicare and Medicaid Services.

The program plans to use an interdisciplinary team to treat the health care needs of cognitively challenges adults in Rhode Island with chronic conditions and Alzheimers, achieving $29.5 million in health care savings in Medicaid and Medicare costs. Subtracting the $14 million investment, that represents a net savings of $15.5 million, according to according to Elaina K. Goldstein, the author of the grant and Associate Research Professor at the University of Rhode Island, which is administering the grant.

However, some critical details were “missing” from the both the news release and the news conference announcing the award, held at the AccessPoint RI agency headquarters, according to Goldstein.

The news conference featured a parade of elected Rhode Island officials – Gov. Lincoln D. Chafee, Sen. Sheldon Whitehouse, Rep. David N. Cicilline – and University of Rhode Island officials – Provost Donald H. DeHayes and President David M. Dooley, all cheerleading the award as an example of innovation and economic good news for the state and URI. “Go URI,” Chafee said in his brief remarks. When Goldstein, about 5 feet tall, finally got to speak, only her forehead was visible from behind the wooden podium. Not participating in the event were the developmentally disabled adults at AccessPoint RI, the people who will be helped by the new program, who were gathered in an adjacent room.

Goldstein told Providence Business News that although the award called for four agencies to participate in the program – including AccessPoint RI, Seven Hills Rhode Island, Cornerstone Adult Services and Generations Adult Day Care Center, only AccessPoint RI will be designed to serve as a new Living RIte center in the program’s first year. The other sites said that they were initially unprepared to handle the projected volume of new clients.

“We are going to be paid for the first year on meeting a set of deliverables in our operating plan scheduled to be rolled out on Aug. 6,” she explained. The award was supposed to have been announced on March 1, but it was not made until July, according to Goldstein.

About 50 percent of the projected savings in the first year will come from treatment of patients with Alzheimers, which Goldstein calculated to be $25,000 per patient per year, by treating the Alzheimers patients at a base center, instead of at a nursing home. People with developmental disabilities will also provide opportunities for cost savings.

“The No. 1 hospital admittance for a developmentally disabled individual is pneumonia, something that is completely preventable,” Goldstein said. Many doctors, she continued, “don’t have scales to weigh people that are accessible to people in wheelchairs.”

Goldstein’s model for Living RIte is based upon the principles outlined in the book by Harvard Business School Professor Clayton M. Christensen and Dr. Jason Hwang. Hwang will be visiting AccessPoint RI to assist in planning the new center for integrated care within the existing agency. Ximedica, the Providence-based design firm, will also be assisting in the design of the new interdisciplinary treatment center.

Another innovation with long-lasting results will be the creation of an Interdisciplinary Disability Health Center at URI, which will train medical, nursing and pharmacy students on how to work as part of an interdisciplinary team, according to Goldstein.

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