WARWICK – Six months ago, Dr. Michael Wagner said Rhode Island’s health care was fragile. Now he says it’s in a state of crisis.
Among the most pressing issues the state continues to face are lagging Medicaid reimbursement rates and a shortage of primary care physicians.
“It is a crisis because we don’t have a sustainable pathway forward,” Wagner, CEO and president of Care New England Health System, said during Providence Business News’ Fall Health Care Summit on Thursday at the Crowne Plaza Providence-Warwick.
Wagner and John Fernandez, CEO and president of Brown University Health, were among five panelists who discussed the state of health care in Rhode Island, collaborations and partnerships and health care access, equity and cost containment.
A second panel spoke about workforce development and education, the role of technology and innovation in the sector, and the opioid and mental health crisis.
In the first panel discussion, Fernandez, the chief executive of the state's largest hospital group formerly known as Lifespan Corp., said improving the state’s reimbursement rates should be the first priority.
“The idea is how do we focus on making sure we fix the money part and then the many other problems,” Fernandez said. “That will also help us fix the primary care shortage.”
Sen. Pamela Lauria, D-Barrington, noted the salaries for providers and reimbursement rates are 20% to 25% lower than in Massachusetts and Connecticut. But it’s also important to increase access to other kinds of care such as dental care as those issues can trickle down and become medical problems patients rely on primary care providers for.
“Our rates are not sustainable to keep our health care workers here or to attract a health care workforce to Rhode Island,” said Lauria, who is a primary care nurse practitioner with more than 25 years of experience at Brown Health Medical Primary Care, formerly Coastal Medical.
On the first panel, Wagner, Fernandez and Lauria were joined by R.I. Health Insurance Commissioner Cory King and Dr. Raj Hazarika, chief medical officer for commercial products at Harvard Pilgrim Health Care, a Point32 health company.
During the second panel discussion, Ana Novais, assistant secretary of the R.I. Executive Office of Health and Human Services, said the state’s health care crisis goes beyond just primary and physical care. There are problems in behavioral health, substance use and social services, too.
Linda Hurley, CEO and president of CODAC Behavioral Healthcare, said paying health care workers adequately in all fields is crucial because it affects competency levels as recruiting and retaining staff is more difficult.
She said that about 10 years ago approximately 70% of employees in behavioral health care stayed in the field for more than five years. Now it's 30% who are staying that long.
“The bottom line is when an individual is entering a field, they want to be able to have child care, to afford a home, to afford a car,” Hurley said. “Compensation is critical … You really need to be able to pay the people that are doing the wonderful job.”
Also on the second panel was Aiden Petrie, managing partner of New England Medical Innovation Center, and Cara Sammartino, Johnson & Wales University health science department chair and professor.
Both Wagner and Novais said one of the bright spots amid these challenges is the state’s Certified Community Behavioral Health Clinics program. Under the program, which launched in October, eight clinics around the state will offer behavioral health care regardless of immigration status, age and whether a patient has medical insurance.
