Rhode Island’s healthcare system is at a breaking point, affecting patients, providers, and hospitals statewide as there are too few primary care and specialty providers to meet rising demand. An aging workforce, provider burnout, significantly lower reimbursement rates for providers and hospitals compared to Connecticut and Massachusetts, and limited incentives for new physicians to practice in the state are fueling a crisis that is currently leaving hundreds of thousands of Rhode Islanders without timely, essential care. Absent intervention, the problem will only worsen.
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At South County Health, President and CEO Aaron Robinson is helping lead efforts to address the problem in Southern Rhode Island—while calling for support of broader statewide action. Robinson has served as President and CEO of South County Health (SCH) since 2019 and currently serves as Vice Chairman of the Hospital Association of Rhode Island (HARI) Board of Trustees. Under his leadership, SCH has taken bold, strategic steps to meet the growing need for primary care in Southern Rhode Island, implementing multi-disciplinary, team-based care approaches. But as Robinson emphasizes, even the most forward-thinking efforts at the local level can’t solve a crisis that demands statewide coordination and investment.
Q&A with Aaron Robinson, President & CEO, South County Health
Q: What’s your view of the current state of primary care and healthcare in Rhode Island?
Robinson: We’re at a pivotal moment. Rhode Island’s healthcare system is at in crisis, facing a critical shortage of primary care and specialty providers and a strained workforce. One-third of our state’s physicians are at retirement age, and the vast majority of physicians trained in this state leave every year to practice elsewhere. Add to that burnout, staffing shortages, and a medical environment often ranked the worst in the nation for physicians to practice—and it’s no surprise patients are struggling to access the care they need.
Estimates suggest 200,000 to 400,000 Rhode Islanders don’t have access to a primary care provider. Some systems are reporting over 20,000 unassigned primary care patients. Thundermist, who serves 60,000 Rhode Islanders was on the brink of bankruptcy a few months ago and financial headwinds remain. Anchor Medical, which serves 25,000 Rhode Islanders will soon close its doors. Add to that, half of the general acute care hospitals in this state have either been through bankruptcy or closed entirely. The signs of a failing health system are everywhere and it is not sustainable. At South County Health, we’ve been sounding the alarm for years in hopes of avoiding a “Washington Bridge” moment. Sadly, we sit on the brink of more program closures, hospital closures, worsened access, and ultimately worse health if nothing is done to fix reimbursement in Rhode Island.
Q: What is South County Health doing to address the shortage of providers and access to care?
Robinson: While the challenges are real, so our mission calls us to forge ahead for progress. At South County Health, we’ve taken proactive steps to improve access for the communities we serve. Faced with our own unassigned primary care patient list of more than 5,000 patients, we have invested heavily in recruiting teams of primary care physicians and advanced practice providers (APPs) who have worked through that backlog. We are also now in a position to accept new primary care patients — with capacity to accommodate an additional 3,000 to 5,000 patients by the end of 2025.
We’re also responding to growing community demand for expanded women’s health services beyond obstetrics. With the addition of four new gynecological providers, we anticipate offering up to 15,000 new appointment opportunities in fiscal year 2026.
Q: What role should the state play in fixing this?
Robinson: The state must act or all improvements and health systems are at risk. Rhode Island’s reimbursement rates are 25–30% lower than neighboring states. That disparity is driving providers and new medical graduates out of state – this cannot continue. Fixing this requires not just funding, but a reimagined policy approach that invests in healthcare as the foundation of community well-being.
That’s why South County Health took the lead in 2024, to bring awareness to the disparity in reimbursement and introduce legislation in an effort to achieve commercial rate parity.
In 2025, we’re proud to join forces with HARI and other health systems in supporting a suite of bills called the Healthcare Action Package—S.0873/H.5790, S.0681/H.5832, and S.0848/H.6095—designed to:
- Increase Medicaid reimbursement rates
- Ensure commercial payments are competitive with MA and CT
- Stabilize hospitals and provider groups financially
This is the first step in addressing the crisis, but the state must also reprioritize healthcare in the budget, improve the practice environment for providers, and implement long-term strategies to retain talent trained in Rhode Island.
Q: What role can the community play in fixing this?
Robinson: We need the community’s voice. You can make a difference by urging your legislators to support these critical bills. Visit hari.org/policy-advocacy/care-in-crisis to send a pre-drafted letter directly to your state representative and senator—it only takes a few minutes.
By supporting these key legislations, the community can help:
- Improve access to care
- Enhance the state’s ability to recruit and retain physicians and advanced practice providers
- Reduce reliance on ERs for non-emergency issues
- Strengthen the overall stability of the state’s healthcare system
Without public pressure and support, we risk continued inaction—and that comes with real consequences.
Q: What can the community expect without statewide action?
Without decisive action at the state level the situation will worsen: patients will face even longer wait times, fewer care options, longer drives to see specialists (sometimes out of state), and a greater reliance on costly emergency services. South County Health, HARI, and our peer health systems are committed to preventing that future. We’re working hard to expand access today but these investments cannot be sustained without legislative action that will sustain care tomorrow. We can’t do it alone—we need the community and elected officials to join us before it is too late.
Visit hari.org/policy-advocacy/care-in-crisis to send a pre-drafted letter directly to your state representative and senator.
