Asked to define the state of health care in Rhode Island, those at the forefront of the sector provided a dismal outlook at Providence Business News’ 2025 Fall Health Care Summit.
“There’s a lot of unbalance,” said Linda Hurley, CEO of CODAC Behavioral Healthcare. “There’s a lot of fear of the unknown.”
And Martha L. Wofford, CEO and president of Blue Cross & Blue Shield of Rhode Island, added: “We are in crisis.”
Hurley and Wofford spoke on the second of two panels at the health care summit on Oct. 30. The topic of discussion: Shaping the Future of Care, which focused on the rising costs of health care insurance, the persistence of health care inequality and where the state stands on addressing substance abuse and access to mental health.
It’s no wonder observers harbor this pessimism, with the state’s health care system shouldering the cumulative impacts of the COVID-19 pandemic; a glaring shortage of primary care physicians; the ongoing opioid crisis; continuously rising health care expenses; a 10-year high for 2026 health insurance premiums; and the Trump administration cuts to federal health care funding.
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DRAWING A CROWD: More than 200 people attended Providence Business News’ Fall Health Care Summit at Crowne Plaza Providence-Warwick on Oct. 30. / PBN PHOTO/MIKE SKORSKI[/caption]
Additionally, in an already overwhelmed system, two hospitals, Roger Williams Medical Center and Our Lady of Fatima Hospital, face the looming possibility of closure. Owner Prospect Medical Systems Inc. declared bankruptcy in January, and prospective buyer The Centurion Foundation has yet to raise enough money to finalize the sale. Combined, the closures would result in the loss of more than 500 beds and hundreds of jobs.
These influences have left providers across the sector “all doing balancing acts,” Hurley said.
At CODAC, this work includes reckoning with an increase in nonfatal overdoses in Rhode Island and throughout the United States.
The U.S. has recorded a 26% decrease in overdose deaths, Hurley said, largely due to “the remarkable proliferation of Narcan,” a medication that reverses overdoses.
“But what we’re not taking into account is those nonfatal overdoses,” she said. “We’re seeing more and more of that.” For every overdose, Hurley said, another 15 nonfatal overdoses occur, with high recurrence rates.
With each overdose, patients incur brain damage that poses new health and financial burdens, Hurley said, such as impacts to executive function, impulse control, memory and other aspects of physical and mental health.
Hurley’s characterization of a health care system in vertigo also resonates with R.I. Health Insurance Commissioner Cory King, who highlighted a lack of investment in primary care as a driving influence.
“When we spend 5% of health care dollars on primary care, it’s unbalanced because primary care is vital to the health of our citizens,” King said. “Primary care also helps manage the other 95%.”
Meanwhile, he noted, poor insurance reimbursement rates dissuade new providers from this foundational aspect of overall health.
Affordability also vexes patients, with continuously rising health care expenses placing “an unbelievable burden” on patients, Wofford said.
“We have a crisis on Rhode Islanders’ abilities to afford the premiums that we are putting out in the market,” she said. “And they are driven by these incredibly high health care costs.”
And costs extend beyond the more obvious, upfront expenses, King noted. Because most employees receive insurance through their workplaces, “when premiums go up, workers take a pay cut.”
Expenses place a disproportionate burden on already disadvantaged populations, Wofford said, noting that these populations already experience the most obstacles navigating the health care system.
These long-standing systemic issues highlight the importance of detailed data, she added, including information “at a very specific racial and ethnic level so that we can see where there are gaps in care.”
Wofford also emphasized the need to invest higher insurance rates into systemic improvements, such as an increase in team-based care for patients. Additionally, the state needs to focus on dismantling administrative burdens on providers, she said.
Dr. Philip Rizzuto, owner of Rizzuto Eyelid and Facial Plastic Surgery and director of The Surgery Center of Rhode Island, encouraged the establishment of a second medical school in Rhode Island as another solution in a multifaceted approach.
Alongside his practice, Rizzuto also teaches at Brown University, currently home to the state’s only medical school.
“Having another medical school in the state of Rhode Island, I think, is a phenomenal idea,” Rizzuto said, expressing a desire for one “that rivals Brown, and or can be better than Brown.”
“It’s a precarious time,” said Adam Martignetti, vice president of state government affairs and advocacy for Harvard Pilgrim Health Care of New England Inc., a Point32Health Services Inc. company, and one that will require a concentrated effort for course correction.
“I think the changes that are being precipitated by the federal government are going to further strain the health care system we have here in Rhode Island and regionally,” he said. But “we cannot continue to pay and do the same thing and expect good results.”
