Pilot To Try To Treat Sickest, Most Expensive Patients

Dr. Robert Master isn't a household name in Massachusetts. But in the world of health care, he's considered a visionary. He's served as medical director for the state's Medicaid program under former Governor Michael Dukakis. But he soon may be known nationwide as the man who revolutionized primary care.

In 2004, Master founded Commonwealth Care Alliance. It's an unusual group that focuses on Massachusetts residents who are eligible for both Medicare and Medicaid. In other words, the neediest, most medically complicated, and most expensive patients in the state. They usually have multiple chronic conditions that mean frequent visits to hospital emergency rooms or intensive care units.

Commonwealth Care has re-imagined primary care for these patients. They get access to doctors 24/7, home visits and an entire, interdisciplinary team of doctors, social workers, mental health experts, etc. to ensure that every aspect of the patient's life is improved. The results are remarkable. Master's patients are healthier. They don't visit the hospital as often, which means in some cases, the cost to treat them has dropped by more than 50 percent.

The health care world has taken notice. Tucked inside the Affordable Care Act are dozens of pilot programs that are testing new ideas in medicine. Bob Master's Commonwealth Care is now part of a Massachusetts pilot program called MassHealth OneCare. For the next three years, OneCare plans enroll 100,000 Massachusetts residents — to see if Master's revolutionary integrated care system can work at larger scale. If it does, in 2015, the Affordable Care Act will expand the program to 20 other states... in effect, transforming primary care for many of the most expensive, most vulnerable patients in America.

As a boy, it was his job to take his uninsured, immigrant grandfather to a large Boston hospital for cancer treatment.

Dr. Robert Master, Chief Executive Officer of Commonwealth Care Alliance

WBUR's Commonhealth As CEO of this unorthdox hybrid — part health care provider, part HMO, part payer — Dr. Bob Master must take on multiple roles.

WBUR's Commonhealth One of the most radical elements of Commonwealth Care is that patients can get a huge amount of medical attention when they need it.

Health Affairs In terms of quality of care, in 2009 Commonwealth Care Alliance scored in the ninetieth percentile or above on Healthcare Effectiveness Data and Information Set measures for comprehensive diabetes care, monitoring for patients on long-term medication, and access to preventive services.