Reduced costs for the State and high marks from members are the benchmarks of Neighborhood’s program for adults with disabilities

Neighborhood’s long-term Rhody Health Partners participants receive quality health care and report high satisfaction as their medical expenses drop by an average of 13.5 percent

Providence, RI (November 3, 2015) - Neighborhood Health Plan of Rhode Island (Neighborhood), rated one of the top Medicaid health plans in America by NCQA for the past twelve years, today announced data shows the plan’s program for adults with disabilities has reduced medical expenses among long-term enrollees by 13.5 percent (see table 1) while surpassing national benchmarks for quality and participant satisfaction.

Neighborhood began enrolling adults with disabilities in April 2008 through the state’s Rhody Health Partners (RHP) program. Rhode Island residents who were deemed eligible for RHP could choose Neighborhood to help manage their care. Approximately 6,800 individuals were enrolled with Neighborhood as of September 30, 2015.

Neighborhood analyzed the cost and utilization patterns of three cohorts of RHP members who were enrolled for at least two continuous years. The experience of all three groups demonstrates the same pattern:

  1. intense investment in primary care medical services by Neighborhood, care,
  2. coordination and the implementation of individualized care plans,
  3. a reduction in the utilization of certain medical services (like Emergency Room use),
  4. a reduction and stabilization of medical spending, and
  5. improved quality measures in the succeeding years.

Change in Utilization - One metric that indicates successful care management and a change in utilization patterns is a reduction in emergency room visits. Data from the most recent RHP member cohort (enrolled between 10/2011 and 9/2012) indicates a decrease in emergency room visits of 33 percent over two years. Other cohorts have experienced similar reductions.

Providing High Quality of Care - The Healthcare Effectiveness Data and Information Set (HEDIS) is a tool used by more than 90 percent of America’s health plans to measure performance on important dimensions of care and service. Over the last four years, the experience of RHP members has consistently ranked Neighborhood in the top quartile among all Medicaid health plans for at least half of the 26 HEDIS measures. Achieving Member Satisfaction - Consumer Assessment of Healthcare Providers and Systems (CAHPS®) is a survey used to measure member satisfaction. 2015 CAHPS results demonstrate that 95% of RHP members would recommend Neighborhood to friends or family. In particular, RHP members report high levels of satisfaction with their health plan, their physician, and their coordination of care.

“All of us in the health care community are continually looking for ways to deliver better care and improve the health of populations while reducing costs,” said Dr. Francisco “Paco” Trilla, Chief Medical Officer for Neighborhood Health Plan of Rhode Island. “This data shows initiatives we are implementing through the Rhody Health Partners program for some of the state’s sickest residents are working.”

About Neighborhood

Neighborhood Health Plan of Rhode Island (Neighborhood) is a non-profit HMO that was founded in 1994 to make sure everyone in the state has access to high-quality, affordable health care. Neighborhood has been rated as one of the top Medicaid health plans in America for the past twelve years and currently serves more than 178,000 members. Neighborhood also recently extended its great service, benefits and value to individuals and businesses through HealthSource RI – the state’s health insurance exchange.

Table 1: Change in Per Member Per Month Costs over 2+ Years by Cohort and Year