R.I. HEALTH INSURANCE COMMISSIONER Christopher F. Koller wants a better understanding of medical cost drivers to inform efforts to control health care inflation in the state.
PBN FILE PHOTO/STEPHANIE ALVAREZ EWENS
By Richard Asinof
Having documented Rhode Island’s projected future need of hospital beds in a report delivered on April 30 to the R.I. General Assembly, the state’s Health Care Planning and Accountability Advisory Council is laying the groundwork for a statewide plan to help control ever-rising care and insurance costs.
At the top of its list is quantifying the “total spend” of the state’s health sector, to help evaluate whether Rhode Island should follow a similar path to Massachusetts. In the Bay State, the state legislature created a cost commission, setting an annual target of total health care spending, with the goal of keeping costs in line with the overall growth of the state’s economy.
At issue is whether the legislature will move toward setting a cap of health care expenditures in Rhode Island, tied directly to the performance of the state’s economy, as a way to control ever-increasing health costs. The first step in that process is an accurate measure of the state’s total spending on health care.
The council’s second task will be to develop a detailed financial analysis of the state’s behavioral health and substance-abuse services, including the public and private sectors, as well as the costs incurred by gaps in services – such as the de facto role played by the state’s correctional facilities in caring for substance abusers because of lack of access to treatment.
A third task on the agenda will be to look at the makeup of the primary-care workforce in Rhode Island, providing analysis that includes nurse practitioners, nurse managers, physicians’ assistants and other staffing related to the expansion of primary-care practices and patient-centered medical homes.
A fourth task will be to develop a comprehensive database related to pediatrics and the care of children in Rhode Island, focused on cost and outcomes.
“Understanding what drives total medical expense is essential to developing good policies and plans,” said Christopher F. Koller, Rhode Island health insurance commissioner, and co-chair of the council. “I support the priorities identified.”