Three years after taking over at Blue Cross & Blue Shield of Rhode Island, Peter Andruszkiewicz is squarely in the middle of the evolution of health care provision and payment in the Ocean State.
The insurer’s president and CEO has set a goal of bringing the annual increase in health insurance rates by the state’s largest health insurer even with general inflation, something that has not been seen for many years. And he has a pretty good idea how it can be accomplished.
Blue Cross has been signing deals with health care providers that get away from the fee-for-service model and move toward bundled payments. A flat fee will cover certain kinds of illnesses/episodes, with the provider then incentivized to be more efficient. And with quality metrics as part of the scheme, the patient should come out the other end healthier as well.
The concept has been talked about for years, but Andruszkiewicz has been making it a reality, as have other regional players in their own ways, including UnitedHealthcare of New England and Neighborhood Health Plan of Rhode Island.
It’s not easy, but change never is. Thankfully, he knows that we don’t have a choice. •