R-Health Supports 11 Greater Philadelphia Practices Participating in Historic Public-Private Partnership to Strengthen Primary Care

Initiative Provides Primary Care Practices with Additional Resources to Improve Coordination of Care

R-Health, a leader in innovative healthcare solutions, today announced that 11 value-based practices supported by R-Health were accepted into the Comprehensive Primary Care Plus program (CPC+), a partnership between payer partners from the Centers for Medicare & Medicaid Services (CMS), state Medicaid agencies, commercial health plans, self-insured businesses, and primary care providers.

R-Health, through the company’s accountable care service division, supported 11 local practices to apply for the program and all were accepted. Each of these practices are part of one of R-Health’s accountable care organizations, Care is Primary ACO or ACCO.

These local Philadelphia area practices include:

  • Founders Medical (Philadelphia, PA)
  • Greenhouse Internists, P.C. (Philadelphia, PA)
  • S. Peter Gross, DO P.C. (Philadelphia, PA)
  • LMG Family Practice, PC (Chalfont, PA)
  • Medical Group at Marple Commons (Broomall, PA)
  • Mt Airy Family Practice (Philadelphia, PA)
  • Ninth Street Internal Medicine Associates Ltd (Philadelphia, PA)
  • North Willow Grove Family Medicine, P.C. (Willow Grove, PA)
  • PIM Associates PC (Jenkintown, PA)
  • Radnor Family Practice (Radnor, PA)
  • Ritner Medical (Philadelphia, PA)

These practices join the more than 2,900 primary care practices nationwide participating in CPC+. This partnership is designed to provide improved access to quality health care at lower costs.

“A robust primary care system is essential to achieve better care, smarter spending, and healthier people,” said Acting CMS Administrator Patrick Conway. “For this reason, CMS is committed to supporting primary care clinicians to deliver the best, most comprehensive primary care possible for their patients.”

Through CPC+, CMS will pay primary care practices a care management fee, initially set at an average of $15 per beneficiary per month in Track 1 and $28 per beneficiary per month in Track 2, to support enhanced, coordinated services on behalf of Medicare fee-for-service beneficiaries. Simultaneously, participating commercial, state, and other federal insurance plans are also offering enhanced payment to primary care practices designed to support them in providing high-quality primary care on behalf of their members.

For patients, this means that physicians may offer longer and more flexible hours; use electronic health records; coordinate care with patients’ other health care providers; better engage patients and caregivers in managing their own care; and provide individualized, enhanced care for patients living with multiple chronic diseases and higher needs.

The five-year model started on January 1, 2017, with CMS soliciting a diverse pool of commercial health plans, state Medicaid agencies, and self-insured businesses to work alongside Medicare to support comprehensive primary care. Public and private health plans in 14 regions across the country signed letters of intent with CMS to participate in this model: Arkansas, Colorado, Hawaii, Kansas and Missouri’s Greater Kansas City region, Michigan, Montana, New Jersey, New York’s Capital District-Hudson Valley region, Ohio and Kentucky’s Cincinnati-Dayton region, Oklahoma, Oregon, Pennsylvania’s Greater Philadelphia Region, Rhode Island, and Tennessee. The markets were selected in August 2016 based on the percentage of the total population covered by payer partners who expressed interest in joining this partnership.

Eligible primary care practices in each market were invited to apply to participate in the winter of 2016. Through a competitive application process, CMS selected primary care practices within the selected markets to participate in CPC+. Practices were chosen based on their use of health information technology; ability to demonstrate recognition of advanced primary care delivery by leading clinical societies; service to patients covered by participating payer partners; participation in practice transformation and improvement activities; and diversity of geography, practice size, and ownership structure.

CPC+ is administered by the Center for Medicare & Medicaid Innovation (CMS Innovation Center). The CMS Innovation Center was created by the Affordable Care Act to test innovative payment and service delivery models that have the potential to reduce program expenditures while preserving or enhancing the quality of care.

In addition to supporting the application process, R-Health will assist each of the practices in implementing and managing their participation in the program. This will include reporting requirements, data analytics, workflow re-design, and best practices for care management.

“The CPC+ program recognizes the importance of primary care and re-empowering primary care leads to healthier patients and better outcomes,” said Nancy Meisinger, R-Health’s Vice President of Clinical Performance. “We are proud to partner with these local practices as we help them continue their transformation to value-based care delivery.”

For more information about CPC+, visit: https://innovation.cms.gov/initiatives/comprehensive-primary-care-plus/

R-Health Announces Expanded Collaboration with Aetna for Value-Based Healthcare Delivery

R-Health, a leader in innovative healthcare solutions, today announced the company has expanded its value-based healthcare delivery collaboration with Aetna.

With a recent contract to provide Direct Primary Care services to Aetna members through the New Jersey Direct Primary Care pilot program for members enrolled in the State Health Benefits Program (SHBP) and School Employees’ Health Benefits Program (SEHBP), R-Health now has four agreements with Aetna, each focused on patient-centered care. The New Jersey program is an enhanced benefit for the SHBP and SEHBP that provides members free access to an R-Health Direct Primary Care physician with no co-pays or deductibles.

R-Health began working with Aetna in 2014, through the company’s accountable care organization, the Advanced Comprehensive Care Organization (ACCO). This started with a Medicare Advantage population and grew to include adult commercial and pediatric commercial populations. These programs deliver care to thousands of patients in Southeastern Pennsylvania.

These innovative collaborations are each focused on improving quality of care and reducing overall costs. This includes encouraging stronger patient engagement, sharing best practices across care teams, implementing evidence-based guidelines, and creating performance-based incentives.

“We are excited to deepen our collaboration with Aetna through the New Jersey Direct Primary Care program,” said Mason Reiner, R-Health’s CEO. “By offering their members who are enrolled in SHBP and SEHBP access to R-Health, members will experience primary care the way it should be. This builds on our existing patient-centered collaborations with Aetna.”

Through the collaborations between R-Health and Aetna, the 195 providers in ACCO have consistently surpassed clinical quality benchmarks in areas such as patient access, control of chronic conditions, preventive cancer screenings, and vaccinations. For example, during the most recent performance year, 86% of ACCO’s diabetic Medicare Advantage patients had HbA1c levels less than 9, and 96% of adolescents had proper immunizations.

R-Health’s Direct Primary Care program in New Jersey is an innovative offering focused on drastically improving the primary care experience by providing unlimited access to a personal physician with no co-pays or deductibles. It offers same-day and next-day appointments, little to no time in the waiting room, evening and weekend hours, phone consultations, and digital access to the patient’s personal doctor.

About R-Health: R-Health delivers more effective care and a better patient experience – all at a lower cost. We partner with employers, unions, insurance companies and TPAs to offer primary care that’s truly collaborative. This is accomplished through the traditional core values of convenient, personal primary care; our innovative data analytics and patient engagement platforms that streamline care, delivering better outcomes, lower costs and a refreshing patient experience; and the proactive management of chronic conditions. R-Health delivers value-based healthcare two ways, through R-Health Accountable Care, our commercial ACO, and R-Health Direct Primary Care, our innovative membership-based primary care model.  For more information, visit www.R-Health.md.

About Aetna:  Aetna is one of the nation’s leading diversified health care benefits companies, serving an estimated 46.7 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities, Medicaid health care management services, workers’ compensation administrative services and health information technology products and services. Aetna’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see http://www.aetna.com/ and learn about how Aetna is helping to build a healthier world. @AetnaNews

R-Health Launches Medicare ACO in Southeastern Pennsylvania

New ‘Care is Primary ACO’ is First Collaborative Medicare Accountable Care Organization of Smaller, Independent Physicians in the Philadelphia Area

R-Health, a leader in innovative healthcare solutions, today announced the company is launching a new Medicare Accountable Care Organization (ACO), Care is Primary ACO. Care is Primary ACO is the first in Southeastern Pennsylvania consisting exclusively of smaller, independent primary care physicians.

This model of care brings together a select group of high-performing, independent primary care physicians to develop an ACO – a network of physicians who collaborate to deliver coordinated care to Medicare beneficiaries. It focuses on the critical shift from fragmented, episodic care to continuous, relationship-based care that stresses prevention and management of chronic diseases.

Care is Primary ACO delivers value-based care by partnering with physicians throughout the five counties of Southeastern Pennsylvania. The value-based system rewards positive health outcomes for patients, instead of a traditional volume-based approach that rewards physicians based on the number of patients treated, not outcomes.

“R-Health believes that primary care has the ability to transform, delivering better, more personalized care to patients at lower costs,” said Nancy Meisinger, Vice President of Clinical Performance at R-Health. “The independent practitioners in this ACO have already demonstrated success through value-based contracts and we expect to achieve even greater outcomes through Care is Primary ACO.”

“High performing independent primary care practices all share the same challenges but historically we have been isolated from each other,” said Dr. Allan Crimm, Managing Partner of Ninth Street Internal Medicine. “The unique collaboration fostered by Care is Primary ACO enables us to leverage our collective expertise, share best practices, and help us all deliver superior care to our patients.”

The Care is Primary ACO currently includes nearly 100 providers, with more high-quality independent practices expected to join. The ACO anticipates serving over 11,000 Medicare beneficiaries through the Medicare Shared Savings Program.

R-Health Appoints Nancy Meisinger as Vice President of Clinical Performance

R-Health, a leader in innovative healthcare solutions, today announced the company has appointed Nancy Meisinger BSN, CCP, MBA, PCMH CCE, as Vice President of Clinical Performance. Nancy is a recognized leader in clinical data and quality assurance and will lead R-Health’s efforts to continue enhancing the clinical collaboration and sharing of best practices across R-Health’s growing network of primary care providers throughout Southeastern PA and Southern NJ.

R-Health delivers more effective primary care and a better patient experience, while reducing the overall cost of healthcare. R-Health offers two value-based primary care solutions that serve employers, insurance companies, and TPAs: R-Health Direct Primary Care, an innovative membership-based approach to primary care, and R-Health Accountable Care.

“Adding Nancy to our team reinforces our commitment to collaboration, the very best quality, and cost-savings for patients,” said Mason Reiner, R-Health CEO. “Nancy is a renowned expert in implementing new care models and workflows in practices to enhance the patient experience and optimize the quality of care delivered. She will focus on helping our practices leverage data analytics to optimize performance.”

Nancy joins R-Health after most recently serving as the Director of Practice Transformation for the Delaware Valley Accountable Care Organization, which consists of 700 primary care physicians and over 105,000 Medicare beneficiaries.

She is also an external reviewer and faculty member for the Patient Centered Medical Home Recognition Program through the National Committee for Quality Assurance (NCQA) and has consulted with the Pennsylvania Academy of Family Physicians. She was also an invited member of an expert panel with Centers for Medicare and Medicaid Innovation on their Comprehensive Primary Care Initiative. Nancy served on the Pennsylvania State Multi-region Steering Committee for the CMS Multi-Payor Advanced Primary Care Practice Demonstration.

R-Health Featured in the News

Over the past few weeks, R-Health has been in the news on multiple occasions. From our announcement on our acquisition of ACCO to our thoughts on the rise of Direct Primary Care in Medical Economics.

You can read the full articles in our In the News section.

R-Health Acquires the Advanced Comprehensive Care Organization (ACCO) Adding Accountable Care Capabilities

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R-Health, a leader in innovative healthcare solutions, today announced its acquisition of the Advanced Comprehensive Care Organization (ACCO), a prominent Accountable Care Organization of independent family, pediatric, and internal medicine practices across the Greater Philadelphia region.

R-Health delivers more effective primary care and a better patient experience, while reducing the overall cost of healthcare. R-Health will now offer two value-based primary care solutions that serve employers, insurance companies, and TPAs: R-Health Direct Primary Care, an innovative membership-based approach to primary care, and R-Health Accountable Care.

ACCO is a direct outgrowth of the Southeastern Pennsylvania (SEPA) Chronic Care Initiative developed by the Governor’s Office of Health Care Reform. This collaborative brought together primary care practices to find ways to meet the goals of the triple aim of healthcare reform. Twelve of the independent private practices involved in the collaborative founded ACCO in 2010.  The organization has since grown to be a leading voice for independent primary care practices in the region, with over 170 affiliated providers.

“By acquiring ACCO, we can expand our offerings, while remaining 100 percent committed to our core values of offering the very best convenient, personal, and effective primary care,” said Mason Reiner, CEO of R-Health. “Through ACCO we aim to deepen our partnerships with payers and health plan sponsors in the region as we work collaboratively to transform healthcare delivery through better care, better health, and lower costs for patients, particularly those with chronic conditions.”

As part of the acquisition, R-Health is adding key ACCO team members to its leadership team, including Auren Weinberg, MD, FAAP as Vice President, Clinical Strategy & Network Development; Sasha Ballen as Vice President, IT & Data Analytics; and Allan Crimm, MD as Medical Director, Accountable Care.

”Independent primary care physicians are uniquely positioned to thrive in the new paradigm of value-based healthcare,” commented Dr. Auren Weinberg, an ACCO Board member and the founder of Lower Bucks Pediatrics in Yardley, PA.  “Joining forces with R-Health provides us with the practice optimization and technology infrastructure we need to continuously improve the quality and efficacy of the care we deliver to our patients while ensuring a vibrant future for independent primary care practices.”