health care

Five Questions With: Lt. Gov. Elizabeth H. Roberts

"How value-based health care delivery can best be implemented in R.I. is the core question in the SIM. "
Posted 6/24/13

Lt. Gov. Elizabeth H. Roberts is creating a legacy of leadership in guiding the implementation of health care reform in Rhode Island.

The latest efforts include coordinating the draft of a state plan to address Alzheimer’s disease. She is also shepherding the State Innovation Model process to develop an innovative plan for the state’s health care delivery system, known as Healthy Rhode Island, whose goal is to win a federal award up to $60 million to implement the plan.

Roberts’ style is one of inclusion, bringing all stakeholders to the table. Providence Business News caught up with Roberts following a half-day summit on payment reform.

PBN: With R.I. Health Insurance Commissioner Christopher F. Koller leaving, how does the landscape change, given how involved he was with so many aspects of implementing health care reform?

ROBERTS: Commissioner Koller has been a major catalyst for change and has led, with others, the transition to an expanded role for primary care and the patient-centered medical home in our health care system.

As health insurance commissioner, he has monitored and restrained the growth of health care costs. He has developed greater transparency to health care costs and has worked with insurers to make significant investments in primary care.

It is our expectation that Commissioner Koller’s successor will continue to push forward these major reform efforts, in concert with the rest of the healthcare reform team, on the executive committee of the R.I. Healthcare Reform Commission, created by Governor Chafee.

PBN: Where is Healthy Rhode Island on its schedule for preparing the SIM proposal?

ROBERTS: Healthy Rhode Island is on schedule for the completion of the two major projects of the SIM grant: the State Healthcare Innovation Plan (SHIP) and the follow-up application to Centers for Medicare and Medicaid Innovation to test an innovation in our health care system.

In this application, the state can request up to $60 million for investments in the new payment and delivery system model to move Rhode Island to a value-driven, community-based, and patient-centered health care system.

There are six work groups that are currently meeting every two weeks, and further information about the groups are available on our website.

A draft of the SHIP for public comment should be available at the beginning of September.

PBN: With the R.I Health Benefits Exchange gearing up, what are the key points that need to be made as part of the communications effort?

ROBERTS: As part of the communications effort of the Exchange, the key points to be made to individuals include:

  • You will be able to find a plan that meets your budget, including financial help if you’re eligible.

  • You will be able to compare plans.

  • All plans are approved by the state and will cover doctor visits, prescriptions and hospital stays.

  • You can check to see if your doctor is in the plan.

  • There will be knowledgeable people who can answer your questions any point online, on the phone or in person.

    The key points to be made to small businesses include:

  • There will tax credits for offering employees insurance.

  • You will be able to maintain your relationship with your broker.

  • You will be able to offer full employee choice.

  • You will be able to find a plan that fits your budget.

  • All plans are approved by the state and will cover doctor visits, prescriptions and hospital stays.

    PBN: What will a value based health care delivery mean for Rhode Island?

    ROBERTS: A value-based health care delivery system should maximize health outcomes for Rhode Islanders as a result of the investment in services used for diagnosis, prevention and patient care.

    How value-based health care delivery can best be implemented in RI is the core question in the SIM.

    We are bringing experts together in Rhode Island as well as tapping prominent outside resources as part of the Healthy Rhode Island grant (the Payment Reform Summit recently hosted at the Brown Medical School is an example).

    The Clinical and Payment Innovation Work Group will be tackling the answer to this question, making sure our health care system is focused on improving the health of Rhode Islanders.

    PBN: What are the benchmarks of success to measure rhode island's implementation of health care reform?

    ROBERTS: We are focusing on the three areas of the affordable care act:

  • Reducing the number of uninsured Rhode Islanders (access).

  • Health insurance reforms.

  • Payment and delivery system changes that meet the triple aim – improved health, better care, lower cost.

    The benchmarks will be:

  • Successful implementation of the exchange and Medicaid expansion, resulting in more Rhode Islanders having health insurance coverage.

  • Implementation of health insurance reforms that make health insurance fair and more consumer-friendly (which are nearly complete after two legislative sessions during which the federal and state health insurance requirements have been harmonized).

  • Improved health of Rhode Islanders and a strong, patient-focused, lower-cost health care system.

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