Health exchange to get airing at PBN summit

Christine Ferguson, the director of the R.I. Health Benefits Exchange, is anxious to win over skeptics in the business community about the new health-insurance exchange.
The exchange will serve as a marketplace for individuals and small businesses to shop and buy health insurance beginning on Jan. 1, 2014. A primary goal of the exchange, according to Ferguson, is to make “prices more predictable and more affordable.” The exchange will have the capability, she believes, to act as a catalyst for innovation in the insurance industry as a way to leverage market share and work with insurance carriers to control steep price increases.
Ferguson will be looking to use the Providence Business News-sponsored summit focused on health care reform, to be held on March 28, from 8-11 a.m., at the Crowne Plaza in Warwick as a platform to further that message.
Over the course of the next several months, as the exchange prepares for its Oct. 1 launch date, Ferguson and staff will be working with businesses, associations, the chambers of commerce and others to answer questions and get them the information they need to feel comfortable with this new concept.
“If we do this right, not only will we be able to make health care more affordable, but we will also be able to foster competition in the insurance marketplace, improve choice for consumers and improve worker productivity by improving the health of all Rhode Islanders,” Ferguson said.
Beginning in the summer, the exchange plans to launch an aggressive public-outreach campaign, including both traditional media as well as social media platforms such as Facebook and Twitter, according to Ferguson spokesman Ian Lang.
Joining Ferguson at the summit as panelists will be Lt. Gov. Elizabeth H. Roberts, R.I. Health Commissioner Christopher F. Koller, Dr. Timothy J. Babineau, president and CEO of Lifespan, Dr. G. Alan Kurose, president and CEO of Coastal Medical, Peter Andruszkiewicz, president and CEO of Blue Cross & Blue Shield of Rhode Island, William E. O’Gara, a partner with Pannone Lopes Devereaux & West LLC, James Roosevelt, Jr., president and CEO of Tufts Health Plan, and William P. Devereaux, a partner with Pannone Lopes Devereaux & West LLC. One of the questions many businesses want to know are the details about what new products health insurers are creating for the R.I. Health Benefits Exchange.
For Blue Cross’ Andruszkiewicz, new health-insurance products are framed by the need to move forward with payment reform, without which health care reform will falter.
“We are working closely with our provider partners to change the way we finance care,” he said. “Our customers are demanding that we use their money more wisely. They want us working with providers to ensure that they are receiving the right care, in the right setting, at the right time.”
For Tufts, which has seen its membership grow to 27,000 in Rhode Island, the state represents an opportunity for growth, according to Brian Pagliaro, senior vice president of sales, marketing and client services.
Among the new products that Tufts is now promoting in the Rhode Island market is what Pagliaro called an “alternative funding method,” targeted at smaller businesses, moving them to something that resembles self-insurance, with monthly level funding.
Similar to the way that employers have moved from a defined-benefit to a defined-contribution approach in the pension world, Pagliaro said that Tufts will be offering a “contributions methodology” for employers.
The final details of the new products and plans – and their rates – that will be offered on the exchange will emerge at the end of June, according to OHIC’s Koller. He cautioned that businesses should not expect to see an immediate decline in health-insurance premiums. “Per-member, per-month costs for health care have never declined in the United States,” Koller said. “There are increasing indications, however, that recent moderations in health care-premium trend increases are not just due to the economic slowdown but some structural changes in how health care is paid for and organized. Here in Rhode Island we are seeing similar moderations compared to five years ago.” Lifespan, the state’s largest hospital network as well as the state’s largest private employer, has embarked on a focused effort to enhance the patient experience while decreasing the costs of health care, according to Babineau. He pointed to the recent collaboration by Lifespan and UnitedHealthcare to create an accountable coordinated- care organization, or shared-savings program. “It will enable doctors across the care setting to communicate and collaborate about a patient’s care to ensure they are providing the right care in the most appropriate setting,” Babineau said.
Both Lifespan and Care New England, the state’s second-largest hospital network, have recently entered into partnership agreements with Epic, a software-technology firm, to create a unified platform for health IT and electronic health records.
For Lifespan, the new system will emphasize a patient-centric model. “This new technology platform, which will be fully implemented by 2015, will provide patients with electronic access to their health information 24/7, enable patient communication with caregivers, eliminate duplicative and unnecessary tests, and provide a system that will pull patient information from different caregivers into a single electronic medical record,” said Babineau. •

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