As part of our ongoing coverage of health reform and the cost of care, CommonHealth will periodically investigate novel approaches to delivering high quality, affordable medical care. We begin the series with a look at Bob Master’s Commonwealth Care Alliance, a nonprofit that has reduced the hospitalization rate of its chronically ill, elderly patients by nearly half since the first enrollee signed on in 2004.Step into the downtown Boston office of Commonwealth Care Alliance, and the first thing that hits you are the walls — they’re a screaming, deliciously bright shade of orange — not the typical palette for a health care business. But that’s the point.
As CEO of this unorthdox hybrid — part health care provider, part HMO, part payer — Dr. Bob Master must take on multiple roles. “We have to play the insurance game,” he says. “But that’s not our primary role.”
Reinventing Primary Care
Dr. Master’s ultimate role has been to re-imagine health care delivery. Commonwealth Care front-loads primary care and supports physicians in its network with a dedicated team of nurse practitioners, mental health and behavioral specialists, geriatric social workers and “every medical and surgical specialist known to man.”
The organization is essentially a full-service provider of medical care and social support for chronically sick, elderly and sometimes disabled people on Medicare, Medicaid, or both. From the moment a patient signs on, he or she has access — 24 hours a day, 7 days a week — to a nurse practitioner who is armed with up-to-date electronic medical records and has the authority to call in other specialists as needed. Patients can choose from 25 primary care sites around the state, and for the homebound, house calls are also part of the plan. Continue reading