R.I. health care system needs to be more focused amid federal policy uncertainty

Every day, patients are worried about receiving care. The nonprofit provides psychiatry and mental health services to some of the most vulnerable Rhode Islanders, said CEO and president Linda Hurley. For example, it treats about half of the state’s substance use patients, with 93% relying on Medicaid. However, recent uncertainty regarding federal government’s reduction in healthcare funding has added to patient concerns for providers and patients, as well as their ability to receive care. “There’s a lot of anxiety,” Harley said. Harley was one of six panelists at Providence Marriott for Providence Business News’ Healthcare Summit and Healthcare Heroes Awards Awards event. The discussion touched on several topics related to healthcare, including workforce challenges, access, affordability, and inequality. In fact, Dr. Michael Wagner, CEO and President of CARE New England Health System, said changes in federal government policies could exacerbate the state’s health care system. Rhode Island and several other states have already seen cuts in federal funding for research and public health programs. Further hits into healthcare funding could mean that some programs and resources may need to be cut, panelists said. “We’re still in danger,” Wagner said. “We could be heading for a catastrophe,” however, Peter Marino, CEO and president of Rhode Island Neighborhood Health Plan, was more optimistic. He noted that state leaders have worked hard to invest in healthcare over the past few years. Still, it is clear that the state is operating on limited resources. Regardless of what the federal government is doing, services are likely to be cut, and the challenges facing healthcare leaders are deciding which to maintain. “It’s about making a priority, choosing what we want to save…and something we might have to throw away to ensure the entire system can survive,” Marino said. Maximizing the state’s healthcare resources requires focus and planning rather than expanding to several things. But the state doesn’t have a comprehensive healthcare plan, making this kind of focus difficult, said Greg Mercurio, senior vice president of radiation oncology at American Shared Hospital Services and CEO of Rhode Island’s Precision Radiation Oncology. “If you don’t have a plan, you don’t know what you need. If you don’t know what you need, you can’t supply it,” Merclio said. It is now up to the individual company or provider to identify and fill healthcare gaps. A recent example was when the American shared hospital services realized that cancer treatments were not being provided to the East Bay area. So the company is currently building a comprehensive cancer centre in Bristol to meet its needs. It is also important to deal efficiently with state shortages and reduce the time spent researching them, Mercurio said. This is especially true in the ongoing struggle to access primary care services in Rhode Island. It is unclear whether there is a single dataset documenting the number of primary care providers available in the state, but panelists agreed that Rhode Island is in the midst of a primary care crisis. The shortage of primary care physicians is driving this issue. As a result, more nurses and physician assistants are taking on additional responsibility. But the lack of housing in the state is hindering training, said Joseph Tranzo, assistant director of the Department of Health and Behavioral Sciences at Bryant University and professor of psychology. Every year, students are accepted into Bryant’s Physician Assistant Program. This means you’ll end up withdrawing your deposit and not find a place to afford to pay for the school, so you’ll go somewhere. Increased provider coverage to attract and retain physicians is also key. The best way to do that is to increase the reimbursement rate for primary care services in Rhode Island, the panelists said. Currently, only 5% to 7% of healthcare funds spent on primary care are spent. But if it rises from 10% to 11%, it will have a “dramatic positive impact” on the state, Wagner said. And when it comes to looking at more expensive resources such as emergency rooms and specialists as patients struggle to find providers, Dr. Raj Hazarika, Chief Medical Officer of Commercial Products at Point32health Services Inc., said technologies such as virtual care are certainly part of the solution. Wagner said Care New England is testing a variety of artificial intelligence technologies, including an overview of automated charts, record and transcription of patient visits, and automated responses to patients that provide a more detailed message. It’s still early, but the results are promising. “Because of all the fate and darkness, I’m pretty excited to actually figure out how to drain our doctors and APCs [advanced practice clinicians] When they try to get their job done,” Wagner said.