; Blue Cross & Blue Shield Of Rhode Island And University Medicine Announce Multi-Year Patient Centered Contract
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Press Release

Blue Cross & Blue Shield Of Rhode Island And University Medicine Announce Multi-Year Patient Centered Contract

Creates partnership to deliver high-quality care more efficiently

July 17, 2013

PROVIDENCE, RI – Blue Cross & Blue Shield of Rhode Island (BCBSRI) and University Medicine (UM) today announced that they have entered into an innovative, three-year shared-savings agreement to further improve healthcare quality and patient safety, while slowing increases in healthcare costs. The state’s largest multi-specialty group, UM’s 200 physicians provide a range of specialty services and primary care, including 6 practices with a patient-centered medical home model.

The contract focuses on improving the patient experience, prevention/wellness, limiting unnecessary hospitalizations, and reinforces the role of the primary care physicians through components including:

  • Expanded After-Hours—UM will expand appointments on weekends and evenings to increase access to care for its patients and reduce medically unnecessary emergency room and urgent care visits.
  • New Health Advocate Resource— The Health Advocate will help patients navigate across care settings and ensure they have the support necessary.
  • Behavioral Health Services Coordination— Collaborative arrangements with behavioral health providers will improve communication and coordination with primary care physicians.
  • Patient Centered Medical Home (PCMH) Neighborhoods—UM’s PCMH program will expand to include specialists, creating a new care model for patients. The program supported by a physician champion will begin with stage 3 and stage 4 chronic kidney disease patients, pairing patients with a nurse care manager, and, in the second year, a pharmacist.

“As the state’s largest multi-specialty group, 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 for BCBSRI. “BCBSRI is committed to aligning incentives that place the patient’s needs at the center, provide the highest quality care, and improve the overall financial health of the system. By partnering with organizations like University Medicine, real change is possible.”

University Medicine’s President, Dr Lou Rice, noted “University Medicine is taking its commitment to primary care and bringing our specialists into the patient centered medical home.  Our 15 year dedication to improving care for Rhode Islanders will be enhanced and advanced by this new relationship with Blue Cross & Blue Shield of Rhode Island.”

Blue Cross & Blue Shield of Rhode Island
Blue Cross Blue Shield of Rhode Island is the state’s leading health insurer and covers more than 600,000 members. The company is an independent licensee of the Blue Cross Blue Shield Association. For more information, visit BCBSRI.com and follow us on Twitter @BCBSRI.

University Medicine
University Medicine is a 200 physician organization covering the divisions of Primary Care, General Internal Medicine, Geriatrics, Hospital Medicine, Rheumatology, Gastroenterology, Nephrology, Pulmonary, Infectious Disease, Endocrinology and Hematology Oncology.  Dr Rice serves the Physician in Chief for the Department of Medicine at Rhode Island Hospital, Miriam Hospital.  He is also the Chairman of Medicine for the Warren Alpert Brown Medical School.  The physicians of University Medicine serve as teachers for medical school students and medical residents in training.    For more information, go to umfmed.org.

The Blue Cross and Blue Shield Association is a national federation of 36 independent, community-based and locally-operated Blue Cross and Blue Shield companies that collectively provide healthcare coverage for more than 105 million members – one-in-three Americans.  For more information on the Blue Cross and Blue Shield Association and its member companies, please visit bcbs.com. We encourage you to connect with us on Facebook, check out our videos on YouTube, follow us on Twitter and check out The BCBS Blog, for up-to-date information about BCBSA.