Four years ago, Massachusetts health officials went looking for insurance companies to try an experimental new public program. The goal: to manage care for some of the poorest and sickest people in the state, help them get better — and reduce costs.
While a few insurers showed some interest, Commonwealth Care Alliance went all in.
Now the small Boston-based insurer and care provider has begun to find success in treating a complex population of patients, including those struggling with chronic diseases, drug addiction, mental illness, poverty, and, sometimes, homelessness.
Every hospital admission, in addition to being disruptive for patients, costs thousands of dollars. Admissions for members enrolled in the program for at least 18 months have dropped by 22 percent. That’s an indication that patients are getting better care before their health problems are so bad that they end up in the emergency room, Commonwealth Care Alliance says.
“It’s a big deal,” says president and CEO Christopher Palmieri. “They’re now getting the right health care.”
The costs of the program, called One Care, are ultimately borne by taxpayers. One Care is for people covered by government-funded Medicare and Medicaid.
Progress is especially satisfying for Commonwealth Care Alliance because the nonprofit company initially struggled mightily with the program. After freezing enrollment and taking other steps to stabilize financially, the company now has more than 13,000 One Care members — and counting.
“Over time, the recipe works,” Palmieri says. “We’ve learned that over time we can have a very positive impact.”