Neighborhood Health Plan says new integrated care initiative showing results

NEIGHBORHOOD HEALTH PLAN of Rhode Island said its new integrated care initiative has helped reduce the number of members living in nursing homes and emergency room visits by 11 percent each and hospitalizations by 6 percent.
NEIGHBORHOOD HEALTH PLAN of Rhode Island said its new integrated care initiative has helped reduce the number of members living in nursing homes and emergency room visits by 11 percent each and hospitalizations by 6 percent.

SMITHFIELD – Neighborhood Health Plan of Rhode Island’s new integrated care initiative has helped reduce the number of members living in nursing homes and emergency room visits by 11 percent each and hospitalizations by 6 percent.
Neighborhood recently released a report highlighting preliminary results of the first phase of its two-part initiative to coordinate benefits for individuals eligible for both Medicare and Medicaid.
Neighborhood, in a press release, noted its Integrated Care Initiative coordinates these programs under one plan.

In operation since November 2013, when Neighborhood partnered with the state on the initiative, the program is designed as a staged transition, with phase I addressing only Medicaid services, and phase II focusing on uniting all benefits under one plan. Neighborhood said it is the only health plan in the state participating in this program.

Serving nearly 22,000 medically needy and economically vulnerable Rhode Islanders, Neighborhood said its work on the ICI has increased member assessments and better coordinated services.

Through the first phase called “UNITY,” Neighborhood conducted more than 40,000 assessments; identified key struggles of membership, including housing availability; and found an 11 percent reduction in members residing in nursing home settings, despite a 27 percent increase in the number of members participating in UNITY, as well as a 6 percent reduction in hospitalizations and 11 percent reduction in re-hospitalizations.

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The second phase, called “INTEGRITY,” is expected to launch this summer, incorporating services including long-term care, and medical and hospital services.

“Neighborhood is eager to build upon our early investments and results in the Integrated Care Initiative,” Alison Croke, vice president for Medicare/Medicaid integration, said in a statement. “Our managed care model has proven to be very effective over the years, and we believe this group of Rhode Islanders will also benefit by working with us.”

Approximately 30,000 residents are dual-enrolled and described as “among Rhode Island’s most medically complex and economically disadvantaged,” according to the report.

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