Patrick Tigue was named Medicaid director for the state of Rhode Island in March 2017, succeeding Anya Rader Wallack, who left that position in September 2016. Before taking the position with the state, he worked at Neighborhood Health Plan of Rhode Island, and earlier for the Rhode Island Office of the Health Insurance Commissioner.
Tigue talked recently with Providence Business News about his responsibilities as Medicaid director and what the future may hold for Rhode Island residents covered by Medicaid.
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PBN: Why has there been so much turnover in the position of Medicaid director in the last few years? Will that impact your ability to fulfill your responsibilities?
TIGUE: Over the last several years, starting before the Affordable Care Act was enacted into law, Rhode Island’s health care market was struggling with the same issues that are affecting many parts of the country. Working in a constantly changing environment can be difficult. I’m ready to hit the ground running in this new position. I’m fortunate to work alongside Acting Secretary of Executive Office of Health and Human Services Anya Rader Wallack, our dedicated Medicaid staff and many providers, health plans and community partners that care about the impact this program has on Rhode Islanders’ lives. These groups will continue to serve as valuable resources to me and to the entire team as we work to deliver the high-quality care and services Rhode Islanders deserve.
PBN: Describe your primary responsibilities as Medicaid director and your highest priorities in the next year.
TIGUE: My top priority is to help our Medicaid program run as effectively and efficiently as possible, so that the Rhode Islanders we serve can get the care they need to live healthy, productive lives. Over the next year, I look forward to working with Gov. [Gina M.] Raimondo’s administration and continuing the efforts that started with the Reinventing Medicaid initiatives. In partnership with the federal Centers for Medicare and Medicaid Services, we will be expanding our use of alternative payment models, to make sure we’re paying for high-quality, well-coordinated care that results in better outcomes for the people we serve.
We’re also partnering with our public colleges and universities to strengthen programming and ensure we have a health care workforce that is ready to meet future health care needs and challenges. We will be paying close attention to potential changes at the federal level and will be prepared to work in partnership with our colleagues across government to keep access to high-quality, affordable health coverage for all Rhode Islanders at the forefront of our work.
PBN: Managing the state’s Medicaid office, which provides benefits to nearly one-third of the state’s population and annually distributes benefits of approximately $3.2 billion, is an imposing obligation. What skills and expertise do you possess to prepare you for this position?
TIGUE: Prior to accepting this position, I served as director of operations and strategy for the commercial side of Neighborhood Health Plan of Rhode Island – one of the largest insurers of low- and moderate-income Rhode Islanders. I look forward to using these skills to improve care for the people served by Rhode Island’s Medicaid program, which provides a critical service for low-income Rhode Islanders, working families and some of our most vulnerable community members.
I also plan to use my background in public policy and health policy to encourage innovation in our Medicaid program that helps us deliver better care and health outcomes, while responsibly managing costs.
PBN: How are your office’s functions impacted by the unsuccessful rollout of the Unified Health Infrastructure Plan, and how will you address that going forward?
TIGUE: The challenges Rhode Island families and providers have experienced with the UHIP system are inexcusable. At Gov. Raimondo’s direction, Rhode Island continues to hold the state’s IT vendor for UHIP, Deloitte, accountable for delivering a functioning system, and we are working to put the necessary pieces in place to best manage this project and serve our customers. My priority is to ensure that my Medicaid team is contributing to and involved in this process to improve UHIP and create better functionality for our customers and providers.
PBN: If the Republican-controlled Congress succeeds in changing Medicaid funding to block grant funding, how might Rhode Island be impacted? What actions could be taken at the state level to minimize any financial impact?
TIGUE: As Rhode Island has demonstrated with its work to Reinvent Medicaid, states can find innovative ways to manage costs while assuring access to high-quality care. Yet they can’t do it in the face of big hits to funding. The challenge with block grants is that they are very often accompanied by funding cuts or they don’t account for the growth in costs of, for example, drugs, medical devices or an aging population.
We estimate that Rhode Island would have needed to increase state general revenue spending by more than $400 million to fully offset the loss in federal funding associated with the per capita cap on spending proposed in the American Health Care Act, (the GOP-sponsored legislation designed to repeal and replace the Affordable Care Act that the House of Representatives narrowly approved on May 4, by a 217-213 vote).
Such a shortfall in federal funding would make it very hard for Rhode Island to maintain the coverage levels we have achieved. Rhode Island has made great progress in recent years to reduce our uninsured rate, which is down from nearly 12 percent in 2012 to nearly 4 percent today. We don’t want to see those gains eroded, and we would look at all policy options to determine how to maintain as much coverage as we could.
Nancy Kirsch is a PBN contributing writer.
