PROVIDENCE – With the national COVID-19 public health emergency set to end in May, health care providers and leaders in the state agree on one thing: the health system in Rhode Island is not on a sustainable path, still grappling with workforce shortages, financial struggles and health inequities.
That’s what panelists said at Providence Business News’ Health Care Summit and Health Care Heroes Awards on Thursday, agreeing that the challenges weighing on the health care system require a collaborative approach.
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“I would describe the health care system as fragile, and I think that’s consistent across the country,” said Corey McCarty, senior vice president and general manager at CCA Health Rhode Island.
The summit, held at the Providence Marriott Downtown, featured two panels of industry leaders who touched on several topics concerning health care in the state, from health equity and affordability to workforce shortage and access to care.
The challenges the Ocean State is facing are not unique: they are mirrored in health care systems across the country. One of them – and maybe the most pressing one – is the workforce shortage, which is affecting nearly every area of the sector.
For years, leaders have been warning of a shortage of primary care doctors that is extending waiting times for patients and leading to overcrowding in emergency rooms.
Dr. Kirsten Hokeness, director of Bryant University School of Health and Behavioral Sciences, said she has seen this firsthand, with physician groups calling and “begging” for nearly graduated physician assistants to apply for primary care positions.
“We are seeing nationally that there are tremendous issues, predicting out to 2024 that we’re going to have shortages upwards of 80,000 in physicians alone,” Hokeness said. “There are a lot of issues that are contributing to the lack of primary care and it’s something we certainly need to dig into.”
But it’s not just primary care. Panelists agree that the same issue is hurting nursing homes, behavioral health and certain specialties. One of the main challenges for Rhode Island is maintaining its attractiveness to potential candidates who might be more inclined to look for jobs out of state, where salaries are higher.
“We’re looking at a significant workforce shortage not just now but in the next five to 10 years. The projections are that this is going to be something that’s going to extend for a substantial amount of time,” said Dr. G. Dean Roye, senior vice president and chief medical officer of Rhode Island Hospital. “We tend to think locally, but we compete regionally and nationally.”
Higher education plays a crucial role in strengthening the pipeline and offering students professional opportunities, said Hokeness. But it goes beyond education. Martha Wofford, CEO and president of Blue Cross & Blue Shield of Rhode Island, said transitioning to team-based care – where not all primary care relies on primary care physicians – might be the solution to many of these problems.
“There’s accountability for us on the payer’s side to create ways to let practices transition to team-based care,” she said. “When that happens, suddenly the PCP can increase their panel size or number of patients, usually twofold.”
Similarly, panelists discussed the advantages of transitioning to value-based health care, which has the potential to lead to higher-quality and lower-cost care. But it’s not an easy transition.
“That transition can be quite complicated,” said Dr. Methodius Tuuli, chief of OB/GYN at Women and Infants Hospital. “Sitting in the specialty care space, one of the challenges is this idea of risk … Value-based care has to account for the fact that I am taking care of more-complicated patients rather than straightforward pregnancy. And then the last part, which is the elephant in the room is how healthcare is not the only thing that influences health outcomes.”
“But I think the concept is that it is a great one,” Tuuli added. “If we can all get there, I think it will be a win for everyone.”
Panelists were asked about the state of the health care system in Rhode Island and the answer seemed unanimous: it’s fragile and something must be done.
“There is something wrong when none of the health care systems are breaking even,” Tuuli said.
On top of the financial hurdles brought by COVID-19, reimbursements remain one of the biggest challenges in the state, where about a third of patients are being reimbursed by Medicaid – notorious for having much lower rates than commercial plans.
“We have a good foundation: we have very good hospitals, our community health centers are terrific,” said Peter Marino, CEO and president of Neighborhood Health Plan of Rhode Island. “The infrastructure is there but you still have to take care of the infrastructure.”
Creating a healthy and sustainable system will require collaboration from every part of the sector, panelists agree.
“Everybody in this room needs to lean in differently,” McCarty said. “We’re spending a lot of money, we’re just not getting the outcomes we need to achieve. That really requires us to start thinking differently. We have many of the pieces in Rhode Island that we need to be successful, it’s about how we collaborate and think about using use those pieces differently to create a more cohesive solution for our patients and customers.”
Also participating in the panel discussions were Eric Swain, United Healthcare vice president of sales and account management in New England; Dr. Claire Levesque, chief medical officer of commercial products at Point32 Health; Kristine Campagna, director of community health and equity at the R.I. Department of Health; and Jane Hayward, co-chair of the Rhode Island Foundation’s Long-Term Health Planning Committee.
During the event, Providence Business News presented Health Care Heroes Awards to nine honorees.
- Career Achievement: Dr. Pablo Rodriguez, Nuestra Salud Productions LLC founder and CEO
- Advancement in Health Care: Dr. Dioscaris Garcia, Brown University Warren Alpert Medical School assistant professor of orthopaedics, assistant dean of diversity, equity and inclusion; and director of the Center for Student Belonging, Recruitment and Retention.
- Health Care Administrator: Dr. Jennifer Ritzau, HopeHealth vice president of medical staff
- Health Care Educator: University of Rhode Island College of Pharmacy
- Mental Health Provider/Advocate: Patricia Fiske, The Groden Network senior director of adult services and director of nursing
- Nurse: Meghan McCoy, Newport Hospital registered nurse
- Nurse Practitioner/Physician Assistant: Kacia Yazbak Toussaint, Westerly Hospital physician assistant
- Home Health Care: Brenda Brassard, PACE Organization of Rhode Island lead certified nursing assistant – home care
- Physician: Dr. Kwame Dapaah-Afriyie, The Miriam Hospital director of the Division of Hospitalist Medicine
Each honoree will be profiled in PBN’s April 14 print edition.
Blue Cross & Blue Shield of Rhode Island was the presenting sponsor for PBN’s Health Care Summit and Health Care Heroes Awards program. CCA Health Rhode Island, Bryant University, Lifespan Corp., Neighborhood Health Plan of Rhode Island, Tufts Health Plan, Women & Infants Hospital and UnitedHealthcare were partner sponsors.
Correction: An earlier version of this story gave an inaccurate amount of Rhode Island residents who are reimbursed by Medicaid. About one third of Rhode Islanders are on Medicaid.
Claudia Chiappa is a PBN staff writer. You may contact her at Chiappa@PBN.com.
