By Richard Asinof
PROVIDENCE – Dr. G. Alan Kurose, president and CEP of Coastal Medical, the state’s largest physician-owned and physician-run primary care group medical practice in Rhode Island, gave a talk at Brown University on Jan. 29, outlining the challenges of transitioning from patient-centered medical homes to an accountable care organization, or ACO.
Kurose was introduced by Dr. Edward Wing, dean of Medicine and Biology at the Warren Alpert Medical School of Brown University. The day before, the medical school had announced a new degree program, combining a medical decree with a masters of science in public health, and Wing talked about the need to train a new generation of doctors with a new focus in a team-centered, data-driven health care.
Under Kurose’s leadership, Coastal Medical has become Rhode Island’s first Medicare Shared Shavings ACO. It has also signed an innovative, shared-savings contract with Blue Cross & Blue Shield of Rhode Island, and begun a program called “Coastal 365,” providing access to health care seven days a week.
Talking to a very knowledgeable audience, which included R.I Health Insurance Commissioner Christopher F. Koller, Lt. Gov. Elizabeth H. Roberts, and Edward J. Quinlan, president of the Hospital Association of Rhode Island, Kurose began by talking about the need to improve quality and lower costs, citing statistics that medical costs consumed 17.9 percent of the nation’s GDP and that within the health care delivery system, between 25-30 percent of the spend was waste.
Kurose explained the importance of integrating the health IT system within a team approach to better manage care and outcomes. He stressed the importance that nurse care managers play within Coastal’s practices. He also called the notion that by simply reducing emergency room visits and hospital readmissions, it was possible to cut medical costs, calling it an urban legend. Instead, the reduction in costs will come through a more comprehensive approach to care, better control of pharmacy costs, and better quality measurements of care.
“If we don’t decide, others will decide for us,” Kurose said, explaining the reasoning for his group’s investment in a new model of health care delivery in Rhode Island.