health care

Costantino again seeks RIte Care cuts

Posted 12/17/12

PROVIDENCE – For the third budget cycle in a row, Steven M. Costantino, the secretary of the R.I. Executive Office of Health and Human Services, has proposed reductions in Medicaid health benefits coverage for adults, as part of $100 million in potential budget cuts offered by his agency.

Under Costantino’s proposal, parents’ income eligibility under RIte Care would be reduced from the current 175 percent of the federal poverty level to 122 percent, saving an estimated $11.2 million, but eliminating about 6,900 parents from health insurance coverage.

Costantino had floated the exact same proposal in June 2011, under the incorrect premise that Rhode Island’s benefits were higher than in the neighboring states of Connecticut and Massachusetts.

That effort was defeated when House Finance Committee members were found to have been using inaccurate numbers to make the comparisons.

Costantino then asked federal permission in August 2011 to make those cuts under the Medicaid program, but his request was denied by the Centers for Medicare and Medicaid Services.

In an interview in February 2012, Costantino told the Providence Business News that his philosophy was to make programs more efficient and move toward greater consolidation. When asked what kind of investments in programs he would consider making to achieve comparable results, Costantino responded: “No one has ever asked me that question. I’ve never really thought about it.”

An example of such an investment can be found at the Blackstone Valley Community Health Center. It was able to bend the medical cost curve in 2011, achieving more than $5 million in savings through avoided medical costs, as a result of investing in integrating health IT data at the point of care.

As a result, the state of Rhode Island received $3.8 million of those savings, which were returned as part of a risk-sharing arrangement with Neighborhood Health Plan of Rhode Island, according to Neighborhood’s chief financial officer, T. Clark Phillip, Jr.

Blackstone’s savings – about 25 percent of the proposed $11.2 million savings from the proposed budget cuts to RIte Care – were achieved from its patient bas of about 11,000 patients.

Neighborhood Health Plan, through the state’s managed Medicaid program, currently serves more than 92,000 members through its network of primary care providers, including all nine of Rhode Island’s community health centers. Following Blackstone’s successful model, and making an investment in integrating health IT data at the point of care at the other eight community health centers, the state has the potential to create savings – and a return to the state of Rhode Island – far greater than Costantino’s proposed budget cuts to RIte Care would achieve. It would also have the added benefit of increasing quality care and create better health outcomes for children and their families, instead of removing health insurance coverage from parents.

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