HEALTHY IDEAS: R.I. Health Insurance Commissioner Dr. Kathleen C. Hittner says that as a next step in the effort to reduce medical-service utilization, she wants the R.I. Chronic Care Sustainability Initiative to bring hospitals into the discussion.
PBN PHOTO/TRACY JENKINS
By Richard Asinof
Dr. Kathleen C. Hittner was retired, and she and her husband were building a retirement home in Hilton Head, S.C., when Gov. Lincoln D. Chafee called and asked her to succeed Christopher F. Koller, the state’s first and only health insurance commissioner during the last eight years.
At first, Hittner was reluctant to return to the health care fray, saying that she had no intention to going back to work. But then, as she told Providence Business News, she realized “There’s no better time to be in this kind of position and help to move the health care system in the next direction.”
Rhode Island is on the cusp of major changes in its health care delivery system. And Hittner, a former hospital CEO, will often be at center stage. She’ll oversee insurance rates, the expansion of the R.I. Chronic Care Sustainability Initiative to more than one-quarter of the state’s 1 million residents, and co-chair the R.I. Health Care Planning and Accountability Advisory Council, charged by the General Assembly with drilling down into health care costs.
PBN: What are your thoughts on the issue of medical costs and medical spending? Do you think that Rhode Island, similar to what Massachusetts has done, will create a cost commission? Or consider a cap of rates?
HITTNER: It’s a critically important part of the work of our organization to do rate reviews. We have a very important part of our directive, which is insuring the solvency of the insurers. So that’s part of what we have to look at.
We just put in for a federal grant, which hopefully we will get, for $2.7 million for rate review, to go more in-depth, to do the kinds of things you’re talking about, to look at costs particularly and also, to make sure people understand what the costs are.
Everybody uses the word “transparency.” I like to say that the people who are using the health insurance will need to understand what they’re paying for, deductibles and things of that nature. Yes, there is a lot of work to be done. But I have a lot of thinking to do and learning to do before the word “caps” enters this discussion, because of the solvency issue.
PBN: What do you see as your role in working toward reducing the rates of medical utilization?
HITTNER: All of this is an extremely complex topic, but I don’t think we can solve the whole thing unless we involve many other players. So, for example, one of the things I want to see happen next, with CSI-RI, which is quite big now, is to involve hospitals and bring them into the discussion. So that the caregivers in the patient-centered medical homes are working with the hospitals to decrease hospital admissions and readmissions, making it a smooth transition. So that the physicians know what happened in the hospital, and can take care of that patient in the office and hopefully keep the patient out of the hospitals.