PROVIDENCE – Presentations by health insurance companies, community hospitals and larger hospital chains have taken up two full hearings of the R.I. Senate Commission on hospital costs chaired by Sen. Joshua Miller, D-Cranston.
Hearings on Jan. 10 and Jan. 19 provided commission members with testimony regarding approaches to the conundrum of containing health care costs, aptly captured in the Commission’s full name, Special Senate Commission To Study Cost Containment, Efficiency and Transparency in the Delivery of Quality Patient Care and Access by Hospitals.
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At the close of the Jan. 19 hearing, Miller told Providence Business News he hopes to be able to draft legislation that responds to the concerns voiced at the hearings and is specific in its focus.
The low-key testimony given by Rhode Island health care leaders in the Senate Lounge on the second floor on the Statehouse stood in stark contrast to the political theater taking place at the very same time in the U.S. Congress, where, led by the new Republican majority, the House of Representatives voted 245 to 189 to repeal the federal health care reform law. The vote was a symbolic act, because leaders of the Democratic-controlled Senate say they have no plans to act on the repeal, effectively killing the measure.
In presentations Jan. 19, executives from Lifespan, South County Hospital Healthcare System, UnitedHealthcare of New England, and Neighborhood Health Plan of Rhode Island elaborated their views.
“There’s no value to secrecy,” said Thomas Breen, vice president and chief financial officer at South County Hospital, reflecting his desire for greater transparency in achieving comparable rates of reimbursement for similar services provided by hospitals.
Breen detailed his community hospital’s efforts to trim costs: a wage freeze, reductions in salaries, increased employee contributions to health insurance, all to achieve a savings of about $4 million. Breen advocated changing the current system away from rewarding fee-for-service and volume, moving toward a system that values and rewards community wellness.
To achieve that, Breen called for enhanced regulatory oversight by the Office of the Health Insurance Commissioner, with a methodology and metrics to evaluate contracts and publicize contract comparisons. He also called for more resources to be made available to enable the commissioner to implement these standards.
Mark E. Reynolds, president and CEO of Neighborhood Health Plan of Rhode Island, recommended that all hospitals adopt the best practices for safe transitions and a continuity of care upon discharge, to prevent unnecessary re-admissions and visits to emergency rooms. He also advocated for community-based settings for evaluation of behavioral health concerns, outside of emergency rooms.
H. John Keimig, president and CEO of Quality Partners of Rhode Island, and Rosa Baier, the nonprofit’s senior scientist, detailed their approach to reduce re-admissions to hospitals in Rhode Island, where about one in five patients are re-admitted to the same hospital within 30 days of discharge. By improving communications and providing coaching, the odds of readmission were reduced by 34 percent, according to Baier.
