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Blue Cross & Blue Shield of Rhode Island executives say the company’s recently announced $2 million assessment study should offer a clear view of what the state’s health-care demand will look like in five years.
“It’s an analysis of the gap between the health-care resources available today and the health-care needs of Rhode Islanders five years out,” Ronald A. Battista, Blue Cross president and CEO, said of the study. “We need to understand the demand side of the equation first, so we have a baseline to work from.”
Blue Cross officials stress that the study will be objective, and that the insurer, which is funding and sponsoring the initiative, will live by whatever the results might show. If the study reveals a pending shortage of supply – the need for a transplant center or an additional hospital, for example – then Blue Cross would “step to the plate” to help fund those resources, Battista said.
“As it stands now, we’re all left trying to make decisions based on anecdotal information,” Battista said. “We think a hospital may need this, or we think an X-ray facility needs that, but nobody knows for sure. We want to know that the dollars we are spending are going in the right direction, and we can’t stand up and say that without this study.”
An advisory committee, composed of more than two dozen representatives of business, government, education and various health-care segments, will provide a layer of objectivity, Blue Cross officials said.
The study, named the “Statewide Health Assessment Planning and Evaluation,” or SHAPE, is being done by two independent research firms: Booz Allen Hamilton Inc. and RAND. It will attempt to answer several questions, including:
How much is Rhode Island spending on health care today?
What is the projected demand for health care in Rhode Island in five years?
How is the market delivering health-care services today?
Researchers will take into account local, regional and national health-care trends and generate several supply-and-demand scenarios based on demographic projections. The study’s final step will be to identify the next steps that should be taken to close whatever gap might exist between the supply and demand for health-care services.
The study won’t include an analysis of the level of reimbursement to providers, nor will it single out any cost controls. Those elements – perhaps the thorniest issues in health care today – likely will be examined later, once Blue Cross has a better handle on the types of health-care service Rhode Islanders will demand in the future.
“In order to do a thorough, objective review, we have to bite this off in reasonable chunks,” Battista said.
Edward J. Quinlan, president of the Hospital Association of Rhode Island, said the association is hoping that the study will accurately project future health-care trends, which he said are sure to change dramatically in coming years given shifts in the state’s demographics.
“Rhode Island is facing some significant demographic changes, and if the study can help quantify how those will affect the type and level of services needed, that would be a positive thing,” he said.
But Quinlan made it clear that any future solutions to the state’s health-care problems ultimately must address the issues of cost and reimbursement. He pointed to the fact that about half of the state’s hospitals are losing money and that employers – amid a sputtering economy – will be hard pressed to continue absorbing double-digit percentage increases for health premiums.
“At some point, there has to be a discussion that will engage all these different parties at the same time,” Quinlan said. “They can’t take place in separate boxes,”
The data-gathering process, which already has begun, will glean utilization information and other statistics from a variety of sources, including Blue Cross, health-care providers, various state agencies (including RIte Care and the Rhode Island Department of Human Services), and federal sources, such as Medicare and the Centers for Disease Control.
Researchers expect to finish collecting the data in February.
Mike Colias can be reached via e-mail at colias@pbn.com
