Core Physicians

Core Physicians provides access to primary care services to more than 70,000 seacoast area residents of all ages, and all demographic and socio-economic backgrounds regardless of their ability to pay. Core Physicians has over 190 providers located in 35 locations across the seacoast. In 2023 Core Physicians supported its mission by providing $3,695,794 in community outreach, benefits and financial support to the community excluding $36,601,075 in uncovered Medicare and Medicaid expenses. Core Physician's primary care services are broken down into three specialties including Pediatrics, Family Practice and Internal Medicine. All Core Physicians primary care practices have received national recognition for its pioneering work in the development of the Patient Centered Medical Home model. (Continued on Schedule O)Core Physicians financial assistance program is available to all individuals who meet the financial eligibility requirements and who live within Core Physicians' specified service area for medically necessary services. In 2023, Core Physicians incurred $51,097 in costs to provide charity care to eligible patients.In order to support the more complex medical needs of our primary care patients and those of unaffiliated patients from across our service area, Core Physicians provides a full range of medical and surgical specialties. Our areas of specialization include the following: Diabetes; Plastic Surgery; General Surgery; Orthopedic Surgery; Vascular Surgery; Neurology; Physiatry; Podiatry; Gastroenterology; Rheumatology; Urology; Women's Health; Medical & Invasive Cardiology; Pulmonology/Critical Care; Allergy; Sleep Medicine; Acupuncture; Infectious Disease; Comprehensive Otolaryngology & Audiology; Endocrinology; Wound Care; LGBTQ Health; and Psychiatry.Our specialty services continue to expand in order to reflect the changing and growing healthcare needs of our community. Core Physicians specialists are board certified. Core Physicians financial assistance program also extends to cover medically necessary specialist professional services for individuals who meet our eligibility requirements.The dental program which is currently part of Core Physicians was originally initiated as a separate affiliated entity in response to a documented gap in the community related to the availability of dental services for children either without insurance or on Medicaid. The dental program is one of several "mission based" specialty medical services Core Physicians provides in the greater Seacoast community. Currently Core Physicians has three dentists and eight dental hygienists who provide dental care. In addition to Core Physicians' program service accomplishments described above, and as noted further below, the Beth Israel Lahey Health (BILH) network engaged in significant activities focused on expanding access to care and services, including underserved patient populations in order to reduce health inequities. There was also a strong focus on continuing to provide high quality care at a lower cost, when appropriate. BILH continues to focus on the behavioral health care needs of its communities as well. BILH Network Accomplishments and Activities - Fiscal Year Ended September 30, 2023Throughout the period covered by this filing, Beth Israel Lahey Health ("BILH") and its affiliates focused on expanding access and services, including to underserved patient populations in order to reduce health inequities. In addition, there was a strong focus on continuing to provide high quality care at a lower cost, when appropriate, as demonstrated by BILH's efforts to leverage community settings, keep care within the BILH Performance Network ("BILHPN"), and allow patients to receive care in their homes. The following highlights specific efforts during the period covered by this filing:Access & Expansion to Pharmacy Services - BILH Pharmacy has continued to expand its contractual relationships, allowing more patients to utilize its pharmacy for their prescriptions. In FY 2023, BILH Pharmacy successfully negotiated access to the Point32Health specialty pharmacy network as well as the WellSense Medicaid Accountable Care Organization ("ACO") plan. Examples of BILH Pharmacy's other efforts to expand patient access to medications include: - Enhanced medication authorization and access services to help patients obtain necessary insurance authorizations and find co-pay assistance, - Expanded the medication refill center to assist patients and providers in expediting medication renewals and ensuring prescribed medication and dosage are still appropriate, - Extended patient co-pay assistance programs to the Joslin Adult Diabetes clinic and Northeast Hospital Corporation patients, and - Expanded clinical pharmacy services in ambulatory clinics to help manage and optimize patients' complex medication therapies. - BILH Pharmacy also expanded its clinical pharmacy presence in clinics to reduce the health equity gap in the use of highly impactful medications to treat patients with diabetes and atherosclerotic cardiovascular diseases by improving their blood pressure and hemoglobin A1C. Interventions centered around prescribing evidence-based medications, educating patients about their conditions, and ensuring access to medication. Initial results have demonstrated an increase in the use of GLP-1 agonists and SGLT-2 inhibitors by 32% in Black and Hispanic populations, an average reduction in hemoglobin A1c of 0.8, and a decrease of systolic and diastolic blood pressures of 7mmHg and 2mmHg respectively.Improvement in Lab Services - BILH optimized the transportation routes of collected laboratory specimens to testing laboratories, ensuring high standards for turnaround times and maximum efficiency. This is foundational to the system's ability to consolidate testing, expand access to in-network laboratory services which in turn generally reduces cost, and support the provision of high-quality care and the clinician and patient experience. - Focus remained strong in developing physician practice delivery models and re-opening patient service centers. These efforts enhance community providers' ability to use BILH labs and increase patient access to BILH labs.Leveraging In-Network Care - BILH operates a Transfer Center that facilitates patient access to the appropriate placement of patient transfers. With the creation of the Transfer Center, BILH has been able to retain patients who might otherwise have gone outside of the system. By expanding its focus to community hospitals, BILH has enhanced its ability to place patients, including at locations potentially closer to the patients' homes. - BILHPN operates a centralized referral management program that focuses on patients seeking out-of-network specialty care and redirecting them to in-network specialty care, when clinically appropriate. Throughout FY 2023, BILHPN redirected well over one thousand patient visits. In most cases, care retained within BILH resulted in enhanced care coordination at a lower cost of care.Enabling Patients to Receive Care at Home - BILH launched its Hospital at Home program in FY 2023, starting with Lahey Clinic Hospital d/b/a Lahey Hospital & Medical Center. This has allowed eligible patients to be offered care in the setting most comfortable for them - their homes - while also customizing care plans and improving patients' mobility even while they are acutely ill. - In FY 2023, BILHPN put programs in place to manage length of stay at skilled nursing facilities ("SNFs"), reduce readmissions, and discharge medically appropriate patients directly to their homes with homecare services instead of to a SNF, provided patients are medically stable to return home after an acute care stay and will likely have better outcomes and lower cost of care.Behavioral Health - In FY 2023, BILH Behavioral Services launched its Community Behavioral Health Center ("CBHC") in Lawrence, Massachusetts, consolidating outpatient, mobile crisis intervention, and adult community crisis stabilization services. The establishment of the CBHC is a part of the Commonwealth's Executive Office of Health and Human Services Roadmap for Behavioral Health Reform. - In addition, as part of the Roadmap for Behavioral Health Reform, BILH launched an Emergency Services Redesign that shifts emergency evaluations out of the Emergency Department ("ED"). BILH Behavioral Services also expanded its ED integration efforts to a total of six EDs, including Addison Gilbert Hospital, Anna Jaques Hospital, Beverly Hospital, Lahey Medical Center-Peabody, Beth Israel Deaconess Hospital-Milton, and Winchester Hospital.(Continued later on this Schedule O)