Rhode Island: It's All in Our Backyard

Setting a national standard for health care from Our Backyard

November 18, 2015 by chris

coastal medicalCoastal Medical is one of the best in the USA at what it does. The physician-owned and -governed health care company ranks in the top 1 percent of Medicare Shared Savings Program Accountable Care Organizations (ACO) nationwide.

That success is rippling throughout Our Backyard. In the process of reinventing its care-delivery system for patients, Coastal has hired 151 new employees while saving a combined $15.3 million across its federal and commercial shared savings contracts last year.

“These results are astounding and hard won. We’ve learned that providing more clinical services to patients is the best way to reduce the total cost of care for a population of patients. We are spending more to save more,” says Dr. Al Kurose, Coastal Medical’s president and CEO.

“That seems counterintuitive, but efforts like our Coastal 365 clinic, our diabetes management program, and our team-based model of care all help to ensure that we are delivering the right care, in the right place, at the right time. That makes care more cost efficient, and gets better outcomes for patients,” he says.

Every one of Coastal’s contracts contains specific quality measures that relate to patient care, and the company strives to meet or exceed the target for a total of 143 quality measures, while at the same time attempting to reduce the overall cost of care for its patient population.

Coastal has been engaged in shared savings contracts with various payers since the beginning of 2012. Current partners include Blue Cross Blue Shield of RI, United Healthcare, Tufts Health Plan, and the Centers for Medicare and Medicaid Services.

Coastal Medical cares for 120,000 patients in 20 medical offices statewide. The group offers 365-day access to sick visits, chronic care management programs, and care teams that support not only patients on a daily basis, but their primary care providers as well.