Updated September 4 at 4:04pm

Insurers meeting goals of increased spending on primary care

According to a new state report, Rhode Island’s commercial health-insurance carriers increased their primary care spending by 37.2 percent between 2008 and 2012.

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Insurers meeting goals of increased spending on primary care


PROVIDENCE – According to a new state report, Rhode Island’s commercial health insurance carriers – Blue Cross & Blue Shield of Rhode Island, UnitedHealthcare of New England and Tufts Health Plan – increased their primary care spending by 37.2 percent during the period 2008-2012.

The report, from the Office of the Health Insurance Commissioner, indicated that Blue Cross, the state’s largest insurer, increased primary care spending from $38.1 million in 2008 to $49.4 million in 2012, a gain of 29.6 percent.

In 2008, Blue Cross’ total spending on primary care represented 5.8 percent of its premium dollars. In 2012, the percentage had grown to 9.4 percent.

The OHIC set standards in 2010 requiring health insurance carriers to increase primary care’s percentage of total premium dollars by 1 percentage point per year from 2010 to 2014.

Blue Cross’s projected primary care spending for 2013, according to the report, was 10.6 percent.

UnitedHealthcare began the period at 5.5 percent primary care spending and ended it at 8.5 percent; United’s projected primary care spending for 2013 is 9.5.

Tufts, which started its coverage in 2009, spent its first year at a 6 percent primary care spending level. Its 2012 percentage was 8.2; and its 2013 projected level was 7.9 percent. Tufts’ results, the report said, were “more uneven than Blue Cross or UnitedHealthCare because of their small, but growing membership in Rhode Island.”

R.I. Health Insurance Commissioner, Dr. Kathleen C. Hittner told Providence Business News that the insurers’ commitment to conforming to the standards was exemplary.

“They have been fantastic,” Hittner said. “They haven’t fought this in any way, shape or form.”

The standards were set by Hittner’s predecessor, Christopher F. Koller, to bring primary care spending up in Rhode Island to the same level as other states, and represents a step away from the fee-for-service system that the Affordable Care Act was designed, in part, to address.

Hittner expects the shift to improve insurers’ profitability, if not immediately. “They haven’t seen much of a change in their bottom line,” she said. “It doesn’t happen quickly. And we don’t have enough of our population in the primary care system the way they should be. At this moment, they have not seen a change in their profitability because of this.”

kathleen c. hittner, christopher f. koller, office of the health insurance commissioner, ohic, blue cross, blue cross & blue shield of rhode island, unitedhealthcare of new england, unitedhealthcare, tufts health plan, tufts, primary care spending, total spending


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