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By Richard Asinof
PROVIDENCE – New legislation to help control health care costs, increase transparency, address market power in Rhode Island passed the Senate on June 4. It now heads to the House.
The R.I. Health Care Reform Act of 2013, 2013-S-540Aaa, would:
n Allow the Office of the Health Insurance Commissioner (OHIC) to monitor the transition from traditional fee-for-service payments to alternative models, including global payments, cost sharing, bundled payments other alternative payments to achieve savings for taxpayers.
n Expand the patient-centered medical home program for individuals with chronic health conditions that are high-frequency users through the state employee health benefit plan.
n Require OHIC, the R.I. Department of Health and the Lt. Governor’s office to develop a report that proposes standards for the certification of affordable care organizations as an alternative structure for care delivery and payment.
n Review the impact of the current mandated health care benefits on the cost of health insurance for fully insured employers.
n Require the R.I. Department of Health to review hospital reporting on pay and compensation and financial disclosure and transmit this information to R.I. Health Planning and Accountability Advisory Council.
n Require the to review health plans’ rate compliance as it relates to state and federal mental health parity laws.
n Institute a state-by-state comparison of health insurance mandates that includes the extent to which Rhode Island mandates exceed other states benefits.
n Establish biannual reports on hospital payment variation, including findings and recommendations.
n Establish additional reporting and transparency requirements for hospitals’ adverse medical errors.
The Senate bill also makes the proposed work agenda of the R.I. Health Planning and Accountability Advisory Council law, including:
n Review the Rhode Island health system’s total cost drivers and provide findings, and related recommendations.
n Coordinate a comprehensive review of mental health and substance abuse incidence rates, capacity and potentially high and rising spending.
n Examine the volume and spending trends for pediatric inpatient and outpatient services, including the evolving role of intensive care units.
n Establish periodic assessments on projected workforce needs among primary care providers, including supply and demand, recruitment, scope and practice, workforce training, incentives and recommendations.
“Slowing the rapid rise of health care costs while ensuring high-quality care for Rhode Island is the goal of this bill,” said Sen. Joshua Miller, chairman of the Health and Human Services Committee and sponsor of the bill. “But it’s important to realize that goal is a moving target, especially at a time when the Affordable Care Act is about to take effect and the state is opening the R.I. Health Benefits Exchange. For that reason, this bill includes a number of elements involving monitoring, reporting and continual evaluation to make sure that when health care needs and costs shift, the health care delivery system evolves, too.”