ConvergenceRI reports that the major Rhode Island hospital systems are “now competing to consolidate community health centers within their networks in order to capture a share of the Medicaid managed care market.”
The state’s biggest system, Lifespan, is in “behind-the-scenes negotiations to recruit community health centers to join their health system network, focused in large part on the Providence Community Health Centers.”
The state’s other system, Care New England, plans to develop and expand its care- management program into the Medicaid market, but more publicly than Lifespan. So, ConvergenceRI reports, Care New England “has filed a grant application with the Rhode Island Foundation {the state’s largest private foundation} to develop a Medicaid program….”
“Prospect Medical, the for-profit parent company of CharterCARE, had earlier acknowledged that it is seeking to acquire a chunk of the Medicaid market in Rhode Island….”
As the publication reports, the systems’ interest is that “community health centers are very good at what they do, providing integrated, coordinated health care at lower costs, and achieving better outcomes. In the patient-centered world of bundled payments across a continuum of managed care, they deliver. And, they are prospering.”
Further, ConvergenceRI reported, “community health centers created some $21 million in savings in 2014 for Neighborhood Health Plan of Rhode Island. Most of those ‘profits’ were passed on directly to the state’s general revenue fund through a risk-sharing agreement with the insurer; very little flowed back to the providers to reward their cost-saving, innovative practices.”
