Safe harbor amid health reform

GOOD NEIGHBORS: Neighborhood Health Plan of Rhode Island saw its revenue jump in 2014 to $829.6 million from $427.6 million in 2012. Above, CEO Peter Marino speaks with Telma Gonzalez, center, and Lizzy Lima. / PBN PHOTO/RUPERT WHITELEY
GOOD NEIGHBORS: Neighborhood Health Plan of Rhode Island saw its revenue jump in 2014 to $829.6 million from $427.6 million in 2012. Above, CEO Peter Marino speaks with Telma Gonzalez, center, and Lizzy Lima. / PBN PHOTO/RUPERT WHITELEY

If there ever was a perfect storm to catalyze the growth of Neighborhood Health Plan of Rhode Island, it was health care reform.

According to President and CEO Peter Marino, the explosive growth that came with passage of the Affordable Care Act has come with logistical challenges – staffing, policy coordination with the state and federal governments, and so on. But Neighborhood always has prided itself on being an agile, compassionate and competent player in the health care market in Rhode Island, even before the reforms took place.

Prior to the company’s appearance on the state’s health-benefits exchange, HealthSource RI, last year to offer plans to individuals and small businesses, it was known primarily for serving Medicaid beneficiaries, including low- and moderate-income families, children with special needs, all children in the state foster care system, and adults with disabilities eligible for Medicaid only.

“The state has looked to us for solutions, to be creative, and to make sure we can ensure good, quality health care at a price that taxpayers can afford,” observed Marino.

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Neighborhood’s revenue nearly doubled from 2012 to 2014 to $830 million, and according to figures it provided, revenue for 2016 is projected to be $1.2 billion.

In November 2013, Neighborhood had 92,000 members; as of July 2015, that number stood at 176,000. Some of this growth is attributable to the expansion of Medicaid through the ACA. But much of it is attributable to the organization’s service to the “duals” population – people who qualify for both Medicaid and Medicare.

As a result of serving this population, Neighborhood bills itself as much as an advocacy organization as it does an insurer. “These folks are a little different than some of the members,” Marino explained. “There’s a much higher demand on the level of service they require.”

These patients frequently have serious conditions complicated by lack of income and access to care over the long term.

“Many members have other things in their lives that make it difficult for them to have good, quality of health,” said Marino of the relationship Neighborhood has with its members. “Many folks are struggling to make sure they have food in the house, and heat. Some people don’t even have a roof over their head. We make an effort to look at all those needs to make sure there aren’t other barriers to great care.”

Marino gave credit to Neighborhood’s staff – a group of about 420 people from diverse backgrounds, such as nursing, social work and customer service – for rising to the daily challenge of providing care to these populations in need.

Furthermore, Marino said, Neighborhood enjoys a reputation among partners and providers for going above and beyond when it comes to its members, whether the children and families of RIte Care (Rhode Island ranks No. 1 in children’s Medicaid health care quality, according to a 2015 report from the Centers for Medicare and Medicaid Services) or the individual and corporate members accessing the group’s coverage through the exchange.

“I was talking with my children’s provider not too long ago, and unsolicited she said, ‘When you’re dealing with Neighborhood, it feels like they’ve put a warm blanket around your shoulders to make sure you get the care you need,’ ” he said. “That’s an interesting analogy for a health plan. People don’t usually describe them in that kind of fashion – it encapsulates the principles we function on: member first, and great customer service.” •

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