The state Department of Health is keeping pace with consumers’ ever-expanding need to know with several new information services available at the click of the Internet. Want to see how your health plan compares to others in terms of preventive care, or how often it denies services?
Doctors, nurses or laboratory workers – want to renew your license without the hassle of writing a check, or see how soon your license expires?
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It’s all becoming possible via the DOH Web site – www.health.state.ri.us – thanks to a new service called “License 2000″ (available this fall) and a just released DOH report that gives 1998 statistics on all major commercial health plans licensed in Rhode Island including Medicare and Medicaid.
Both services were introduced with great fanfare earlier this month.
License 2000 will provide comprehensive support and access to health department licensing, including applications and renewals, information and license verification requests, fiscal accountability, complaint and compliance processing and database updates.
Consumers will be able to get up-to-date information about health care providers, including professional disciplinary actions over the past 10 years and inspection information for restaurants and other facilities.
License 2000 will provide public access to licensing information through the DOH Web site, current as of the previous business day. And health professionals and other licensees will also be able to pay for new licenses or renewals with a charge card, said Patricia A. Nolan, director of the state Department of Health.
”The beauty of License 2000 is that it’s easy and effective,” because it reduces the turnaround time for processing applications, Nolan said. “We’ve eliminated the need for most paper files, check processing and trips to state offices,” and the service is also secured for quality assurance and confidentiality. ” It’s ‘one-stop service’ for licensees and the public.”
Besides more than 87,000 active health professional licenses (physicians, dentists, nurses, pharmacists, etc.), the health department also processes more than 30,000 other active licenses and registrations, including hospitals, nursing homes, laboratories, restaurants, public water supplies and more. All told, 80 professions and 470 categories of health licenses will be administered through the new system.
License 2000 took more than two years to develop, including staff training and data conversion from 43 separate databases and paper-based records. Health department staff worked closely with the Rhode Island State Treasurer’s Office to assure arrangements for the financial procedures and computer technology. System Automation Corporation of Calverton, Md., lead contractor on the project, owns the software for License 2000.
Health department officials expect the system to be a licensing prototype that can meet the needs of other state departments and agencies.
Checking up on health plans
Everything you wanted to know about your health plan but couldn’t wait on the phone long enough to ask is now posted at the DOH Web site – www.health.state.ri.us/planstats/home.htm – which according to Nolan means better access for all Rhode Islanders to official information than they ever had before.
Topics include access, availability and use of health services, plan stability, financial operations and utilization review – plus an entire section on prevention – and benchmarks on the site enable consumers to compare measures for health plans with state-wide results and in some cases, with New England or national statistics.
”People can use the report to get a sense of plan performance in 1998,” Nolan said, although two of the plans from that year -Harvard Pilgrim and Tufts – are no longer operational.
Noting that it’s critical to track performance over multiple years, Nolan said the department expects to receive 1999 data this month and to produce an updated report in October.
Among the report’s multiple findings for 1998:
Commercial health plans spent 87 cents out of every dollar in premiums on member health care services.
Rhode Island’s rates on childhood immunizations, advising smokers to quit, screening for breast cancer and first trimester prenatal care – key measures of preventive services – all exceeded national and New England averages.
Denials of requests for prior authorizations occurred less than 1 percent of the time, and nearly half of appeals by members succeeded.
The new report on health plans was developed out of the 1996 Health Care Accessibility and Quality Assurance Act, which in addition to reporting performance information requires the DOH to certify all health plans in the state, oversee access and quality and investigate complaints.
Other statistical information available via the DOH Web site include the Consumer’s Guide to Health Plans (www.health-.state.ri.us/consumer.htm) and Health Plan Disclosures (www.health.state.ri.us/consumer/home.htm) which provides plan-specific information about policies and coverage; and information on quality of health care relating to physicians (www.doc-board.org/ri/main.htm) and nursing homes (www.health.state.ri.us/hsr/facreg.htm).
For those without Internet access, single paper copies of the health plan statistics report are available by calling 222-2231.
