GROUP THINK: Donald Nokes, president of the Rhode Island Business Group on Health, reviews documents with interim Director Kate Kennedy.
PBN PHOTO/MICHAEL PERSSON
By Richard Asinof
In response to the changing landscape of health care delivery in Rhode Island, the state’s largest business group focused on health issues is repositioning itself in the market and evolving in its focus, message, advocacy and outreach.
The nonprofit Rhode Island Business Group on Health, which calls itself “the voice of Rhode Island business on health care,” has more than 70 corporate members representing some 130,000 employees. It launched a redesigned website Aug. 31 and hired a new interim director, Kate Kennedy.
RIBGH still maintains a strong, forceful presence in efforts to reduce and limit increases in health-insurance premiums for businesses in Rhode Island. Its president, Donald Nokes, has been a frequent critic of rate hikes in health-insurance premiums meetings and forums this past year.
Nokes, also president of NetCenergy in Warwick, told Providence Business News that the focus of RIBGH’s activities is evolving.
“I used to be very focused on the issue of capacity, and capacity planning, because from a business perspective, we understand how important it is that you are right-sized, and that you are not paying for capacity that you are not utilizing,” Nokes said. “Overcapacity for a business guy means that the process is inefficient and expensive.”
Now, Nokes continued, the focus has shifted to “the issue of transparency and the cost that gets negotiated in the reimbursement rates between health insurers, hospitals and providers.”
One of the top priorities in 2012 for RIBGH is increasing transparency to ensure that consumers can evaluate all providers based on cost and quality, according to Nokes.
Other top priorities include encouragement for businesses to create workplace-wellness initiatives and the creation of value-based health-insurance plans that incentivize healthy behaviors and informed consumer choices.
RIBGH has also decided to get into the weeds of the health care delivery system to push and promote the adoption of patient-centered medical homes as the most cost-effective way to deliver primary care, increase access, reduce medical costs and make health insurance more affordable.
At its annual summit, held Sept. 21 at the Providence Marriott Downtown, RIBGH led an in-depth, educational workshop for its business members, advocating for patient-centered medical homes. The summit began with a presentation by Dr. David Keller and Debra Hurwitz, co-directors of the Rhode Island Chronic Care Sustainability Initiative.
It was followed by a discussion of the three commercial health insurers in Rhode Island – Blue Cross & Blue Shield of Rhode Island, UnitedHealthcare of New England and Tufts Health Plan – about their ongoing experience in developing and sustaining patient-centered medical homes. The summit ended with an exhortation from R.I. Health Insurance Commissioner Christopher F. Koller naming the “things employers can do” to spread the patient-centered medical home. They included: educate your brokers, push your insurance brokers, demand and buy more innovative benefit designs, and “be the change you want to see.” Koller said he envisioned a day when the billboard in Pawtucket above I-95 where drivers enter Rhode Island would herald the state as the national leader in patient-centered medical homes.
Dr. Gus Manocchia, senior vice president and chief medical officer at Blue Cross, said the evolution in the group’s strategy was a very positive and natural process.
“I think the idea of a sophisticated employer interested in what goes on in these kind of patient-centered, medical-home, primary-care practices – and what kinds of care their employees are receiving – is critically important,” Manocchia told PBN. “It’s very different than the way that [RIGBH] has done business over the years. It’s important for both employers and employees, he continued, to have information “that supports what’s happening in these practices, whether it’s cost containment, quality-improvement activities or patient-satisfaction surveys.”
Further, Manocchia stressed that it was important for everyone – employers, employees and patients – to be engaged in the process and asking a lot questions. “We need to make it as transparent as possible for all the stakeholders involved,” he said. “Particularly for the patients that are experiencing the care.”
For Dr. Deidre Gifford, medical director at the R.I. Executive Office of Health and Human Services and former director of the R.I. Chronic Care Sustainability Initiative, the RIBGH summit was a testament to the fact that the development of patient-centered medical homes had reached a tipping point – in part because of RIBGH’s educational and advocacy efforts in the last few years.
“When we first started talking to them about patient-centered medical homes a few years ago, we had maybe five medical homes in the state, and the response was: I can’t tell my employees to go find a medical home, because there are only five of them, and they can’t serve everybody.”
Today, Gifford continued, “37 percent of the primary-care doctors practicing in Rhode Island are now [doing so] in a patient-centered medical home – some 447 primary-care doctors out of 1,100 practicing primary-care doctors.”
RIBGH, Gifford said, has been “our side from the very beginning,” and their advocacy has helped move the needle to get to a critical mass. “We’re getting to the tipping point,” she said. “Now the business community can look around and say, OK, it feels legitimate to say to their employees: Go find a patient-centered medical home because they are really out there.” •