Neighborhood and CharterCARE Provider Group Create New Accountable Entity to Improve Care and Reduce Costs for Medicaid Participants

Neighborhood’s first Accountable Entity partnership with a hospital-based group will serve more than 3,000 patients; supports state’s “Reinventing Medicaid” initiative to better align provider payments with high-quality care

Smithfield, R.I. (August 16, 2016) – As part of its ongoing efforts to reshape and reinvigorate health care delivery and payment systems, Neighborhood Health Plan of Rhode Island (Neighborhood) today announced it has partnered with CharterCARE Provider Group RI, LLC (CPGRI) to launch an Accountable Entity (AE).  This AE is expected to improve the delivery of health care services to approximately 3,300 Rhode Islanders enrolled in Neighborhood’s Medicaid managed care plans and served by CPGRI providers.  

CPGRI is affiliated with CharterCARE Health Partners, which includes Our Lady of Fatima Hospital, Roger Williams Medical Center, and St. Joseph Health Center, as well as a statewide network of primary care providers.  

Accountable Entities guide the transition away from traditional fee-for-service models of payment for Rhode Island’s Medicaid-eligible residents.  Quality of care is emphasized, rather than quantity of services provided.  This partnership with CPGRI marks the fourth AE created by Neighborhood and will seek to generate shared savings for the providers, insurer, and the state.

Accountable Entities are a key part of Neighborhood’s long-term strategy to help improve our healthcare system and encourage overall quality while delivering care at a price taxpayers can afford,” said Peter Marino, President and CEO of Neighborhood Health Plan of Rhode Island.  “CPGRI and its provider partners have great experience serving people with low-income and health disparities, so we think there is a lot of potential in deepening our relationship.” 

Joining forces with CPGRI furthers the overall goal of creating better health outcomes for more of Neighborhood's members as well as generating significant savings in the state budget.  These efforts support Governor Gina Raimondo's "Reinventing Medicaid" initiative and share the ultimate goal of expanding vital health services and shifting the state's Medicaid system toward a structure that rewards better outcomes, better coordination and higher-quality care.

"CharterCARE Health Partners, together with its affiliated Independent Practice Association (IPA), CharterCARE Provider Group RI, continues to lead the way as our state advances the Accountable Entity goals of national health reform,” said John J. Holiver, CEO of CharterCARE. “Our sophisticated population health management capabilities will assure that Neighborhood’s patients covered in this contract will receive quality health care at the right level and time, and that our state’s Medicaid program will enjoy significant savings at the same time.”

This partnership represents a step towards the state’s ultimate goal of having 25% of Rhode Island’s Medicaid-eligible residents be enrolled in an AE by 2018.

About Neighborhood
Neighborhood Health Plan of Rhode Island is a non-profit HMO that was founded in 1993 in partnership with Rhode Island’s Community Health Centers.  Neighborhood currently serves more than 185,000 members, including six different Medicaid populations and individuals and businesses through HealthSource RI – the state’s health insurance exchange.  Neighborhood has been rated by National Committee for Quality Assurance (NCQA) as one of the Top Medicaid Health Plans in America every year since ratings began.  

About CharterCARE Provider Group RI
CharterCARE Provider Group RI is an independent practice association (IPA) comprised of more than 500 participating primary care and specialty providers. It’s affiliated with CharterCARE Health Partners, Rhode Island’s first coordinated regional care organization, a joint venture partner with Prospect Medical Holdings. CharterCARE owns and operates a multi-level network of health providers that, using advanced case management methodologies, provides individuals with the right level of health care, at the right time and place, and at lower costs of care delivery. Its member affiliates are: Roger Williams Medical Center, Our Lady of Fatima Hospital, Elmhurst Extended Care, Roger Williams Cancer Center, Southern New England Rehabilitation Center, CharterCARE Home Health Services, St. Joseph Health Center and CharterCARE Medical Associates.

Contact: Jim Armstrong
(401) 459-6189