Two pieces of Rhode Island news in the last few weeks are a sign that the state's leaders are not sitting back and hoping health care spending contains itself.
Gov. Gina M. Raimondo stepped into the ring first, launching a statewide initiative to innovate how health care is delivered and paid for. She appointed a commission to craft the details of reform based on these four overarching goals – cap health care spending in the state; tie the vast majority of health care payments to quality by 2018; implement the next generation of health-information technology to improve care and cut waste; and integrate national health and wellness goals into the state's health care and wellness delivery system.
Next up was R.I. Health Insurance Commissioner Kathleen C. Hittner, who adopted new standards for delivery and payment of health care, including increasing the percentage of patient-centered medical homes as well as requiring insurers to increase the portion of insured medical payments that are made through alternative (i.e., quality-based) measures.
In both cases the state government is taking an active role in trying to corral this most untamed piece of the economy. But how could it be otherwise?
If Rhode Island does not stop diverting an ever-increasing piece of its economy to health care spending, there soon will be little left to invest in other compelling public needs.
Since the health care system has not shown an ability to rein in spending by itself, the public sector has been forced to step in. And correctly so, given the stakes of the issue. •