CharterCARE and UnitedHealthcare to Improve Medicaid Patients’ Health and Health Care in Rhode Island

November 16, 2016
  • Accountable care collaboration to enhance how the health system cares for patients
  • More resources committed to sharing information and coordinating patient care

CharterCARE Health Partners, CharterCARE Provider Group RI, LLC, and UnitedHealthcare Community Plan of Rhode Island have launched a Medicaid accountable care program to improve health outcomes, increase patient satisfaction and reduce the overall cost of care for people enrolled in UnitedHealthcare Medicaid plans.

UnitedHealthcare is collaborating with physician groups as part of the State of Rhode Island Accountable Entities Pilot to improve coordination of care for people enrolled in Medicaid. Approximately 5,000 people enrolled in UnitedHealthcare's Medicaid health plans in Rhode Island will benefit from this collaboration with CharterCARE.

The Reinventing Medicaid Act of 2015 is a comprehensive, progressive package of reforms that positions Rhode Island to improve access to high-quality care and achieve more than $100 million in annual Medicaid savings without cutting Medicaid eligibility or reducing benefits, according to the state.

"From day one, the top priority in our work to transform Medicaid has been to provide Rhode Islanders with better care and achieve healthier outcomes for more people," said Rhode Island Gov. Gina M. Raimondo. "Accountable entities like these will reward collaboration and help shift our entire health care system toward a structure that pays for outcomes and quality, rather than volume of services. I commend CharterCARE and UnitedHealthcare for leading the way in this effort."

UnitedHealthcare, the CharterCARE system and CharterCARE Provider Group RI will work together to better coordinate patient care by using shared technology and information about emergency room visits and hospital admissions, and services that help patients manage their chronic health conditions and encourage healthy lifestyles. The accountable care program also changes the incentives so that care providers have a shared responsibility for the overall cost of care, moving away from a system that reimburses for quantity of services provided to one that rewards the quality of patients' health outcomes and has the potential to reduce overall costs.

"Through this accountable care collaboration with UnitedHealthcare, we are well positioned to increase services and offer more enhanced patient care for Medicaid enrollees," said John J. Holiver, FACHE, CEO of CharterCARE. "This new relationship will enable us to start applying our innovative Prospect Coordinated Regional Care model to improve health outcomes, increase patient satisfaction and reduce the overall cost of care for people enrolled in Medicaid."

UnitedHealthcare will support overall population health, giving the entire care team clear, actionable data about individual patients' health needs, potential gaps in care and proactive identification of high-risk patients. Community-based health workers and care managers will support community-based care coordination, such as helping with planning after a patient is discharged from the hospital and scheduling follow-up appointments.

"We look forward to working with the CharterCARE system and CharterCARE Provider Group RI to enable people to receive more personalized and better coordinated care, which will significantly enhance  their ability to live healthier lives," said Patrice Cooper, CEO of UnitedHealthcare Community Plan of Rhode Island.

UnitedHealthcare serves nearly 300,000 Rhode Islanders with a network of 15 hospitals and more than 4,500 physicians and other care providers statewide.

Nearly 15 million people enrolled in UnitedHealthcare plans across the country have access to accountable care programs, delivered in part through more than 800 accountable care arrangements nationwide as the organization engages in deeper, more collaborative relationships with physicians and hospitals.

Care providers nationwide are showing strong interest in a shift to value-based care. UnitedHealthcare's total payments to physicians and hospitals that are tied to value-based arrangements have tripled in the last three years to more than $52 billion. By the end of 2018, UnitedHealthcare expects that figure to reach $65 billion.

For more information about UnitedHealthcare's full spectrum of value-based initiatives, visit

About CharterCARE Health Partners

CharterCARE Health Partners is a coordinated regional care network comprised of two acute care hospitals, a large nursing home facility, a regional cancer center, a rehabilitation center, a community primary care center and a home health services company. CharterCARE also operates a school of nursing. CharterCARE Provider Group RI, LLC is large independent practice association (IPA) with more than 500 providers closely aligned with the CharterCARE system. Our coordinated regional care model allows us to deliver services to patients at multiple levels of care, at the right time and place and at lower costs. This way of organizing and delivering health care services enables us to optimize population health management strategies in Rhode Island. CharterCARE is a joint venture company that leverages both the health care management expertise and capital strength of Prospect Medical Holdings, Inc., a California-based company that owns and operates hospitals in Texas, California, Pennsylvania and New Jersey.

About UnitedHealthcare

UnitedHealthcare is dedicated to helping people nationwide live healthier lives by simplifying the health care experience, meeting consumer health and wellness needs, and sustaining trusted relationships with care providers. The company offers the full spectrum of health benefit programs for individuals, employers, military service members, retirees and their families, and Medicare and Medicaid beneficiaries, and contracts directly with more than 1 million physicians and care professionals, and 6,000 hospitals and other care facilities nationwide. UnitedHealthcare is one of the businesses of UnitedHealth Group (NYSE: UNH), a diversified Fortune 50 health and well-being company. For more information, visit UnitedHealthcare at or follow @myUHC on Twitter.