State employee health insurer GIC to partner with for-profit Iora Health

April 11, 2017
Boston Business Journal

By: Jessica Bartlett

The Group Insurance Commission, the quasi-state agency the oversees health insurance for state and some government employees, will partner with Iora Health starting this summer to provide specialized health care to around 2,000 people in an attempt to save the state money.

Boston-based Iora, a for-profit health system that's been providing primary care to patients over the age of 55 for years, will be available to those members who are enrolled in the UniCare plan through the state and also live near Iora offices in Medford and Hyde Park. Iora's goal is to establish a closer relationship with patients to improve health and lower the cost of care. For instance, patients have longer appointments with their doctor, as well as shorter wait times for appointments. Iora boasts that members have seen lower hospitalizations, lower ER visits and reduced visits to specialists as a result.

"Making Iora Primary Care available to our members, with the added benefit of $0 copays for office visits and certain medicines, further enhances the value of our offerings to UniCare GIC members," said Dr. Bob Sorrenti, medical director of UniCare.

UniCare will pay Iora a monthly amount per-member, ultimately lowering the bill for the state by caring for patients on a budget.

UniCare, one of several types of insurance offered by the GIC, claimed over 118,000 members in 2016.

In addition to UniCare, Iora provides services outside the GIC to Tufts Medicare Preferred HMO members and Senior Care Options plan holders who are over 65 years old out of their Hyde Park and Medford offices. It also serves the New England Carpenters Benefits Fund out of an exclusive location in Dorchester.

The partnership with Iora is the latest effort the GIC has made to lower the state’s health care bill. Nearly 70,000 state and government employees will have to pay more as of July 1, including higher co-pays for higher-priced providers, increased deductibles and new pharmacy deductibles. The proposals are slated to save $51.5 million in the first year alone.

The state will save an additional $65.5 million by renegotiating pharmacy contracts with its pharmacy benefit manager, implementing caps on hospital and doctor reimbursements, and moving some retirees into a new pharmacy program.

Read BBJ article