Reimbursement plays key in health of state’s medical care

Posted 12/6/23

STORY OF THE WEEK: As Rhode Island edges closer to 2024, policy and politics are converging in a way that could influence the 2026 race for governor. Attorney General Peter Neronha, who is …

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Reimbursement plays key in health of state’s medical care


STORY OF THE WEEK: As Rhode Island edges closer to 2024, policy and politics are converging in a way that could influence the 2026 race for governor. Attorney General Peter Neronha, who is contemplating a run for the state’s top job, said his decision will hinge on whether he believes sufficient progress is being made in addressing climate change and healthcare in the state. On the latter, the AG calls the uncertain future of Roger Williams Medical Center and Our Lady of Fatima Hospital a warning sign of wider problems. “Long-term, all of healthcare in Rhode Island needs to be stabilized,” Neronha told me on Political Roundtable at The Public’s Radio this week. “It is not an issue that is unique to these hospitals – they are in a sense a canary in a coalmine.” He said the necessary steps for shoring up the state’s healthcare and hospital landscape include fixing the reimbursement rate for Medicaid and Medicare — both of which lag other states — and focusing on the commercial reimbursement rate while boosting efficiency and excellence. Addressing all this is a huge lift, to put it mildly, particularly when Neronha cites a need to streamline how healthcare is regulated, given how responsibility is currently divided between the Health Department, the Office of Health Insurance Commissioner, and parts of the Executive Office of Health and Human Services. Neronha has been beating this drum for a few years, but he said progress remains elusive. “Healthcare executives from Rhode Island are consistently coming to my office to strategize and talk,” he said. “They recognize, I think, that any plan that’s going to be able to be implemented is going to have to come from my office in the next couple of years.”

SHOWDOWN: When AG Neronha taped Political Roundtable with me last Wednesday, he said he was unsure if he would heed an order by Superior Court Judge Daniel Procaccini to appear in court. A day later, Neronha filed a motion seeking to quash the order. While Procaccini appeared concerned by a Neronha tweet about jury-waived trials, the AG said his critique is based on policy — how Rhode Island is an outlier in not requiring prosecutors to sign off for a bench trial. Neronha’s motion to vacate the order to appear before Procaccini – now scheduled for Dec. 8 – will be decided by…Judge Procaccini.

PROTEST: A Brown University vigil for math and archeology double major Hisham Awartani – one of three young Palestinian-American men shot by a man in Vermont – began quietly on Monday. University President Christina Paxson got shouted down by students, some who said Brown moved too slowly in addressing anti-Arab sentiment on campus. Faculty members joined students in calling for the university to divest from companies and stocks with ties to Israel. As my colleague Olivia Ebertz reported, Brown also announced that criminal charges would be dropped against 20 Jewish students arrested during a pro-Palestine protest in early November. Elsewhere, National Review’s Zach Kessel reported that Paxson omitted a reference to Jewish students included in her prepared remarks for the vigil. A university spokesman told Kessel that Paxson abbreviated her comments – intended as a call for tolerance for Arab and Jewish students, staff and faculty alike — “with the hope of being able to finish. It’s not unusual for there to be some deviation between remarks as prepared and remarks as delivered, and certainly that was the case here given the disruption.”

MEDIA: The Providence Journal building looms over Fountain Street as a reminder of a bygone era. The Providence Phoenix is gone. And now Providence Associated Press correspondent Michelle Smith shares word via X that the wire service’s longtime office on Dorrance Street is closing. This has particular resonance for your humble correspondent since my introduction to Rhode Island came during a late ’80s seven-month temporary assignment in the AP bunker. It was where Dave Pyle schooled me on the correct pronunciation of “Pawtucket,” not to mention the importance of coffee milk, closely reviewing your own reporting, and savoring the local tendency for colorful and outrageous stories. The office was kitty-corner from City Hall (my car once got towed when I worked late on a Friday, unaware that I was in the reserved spot for the Haven Bros. truck) and the local FBI office used to be in the same building. An older technician minded the technology of the day, including a wire machine that printed a ceaseless stream of national and international headlines. A number of fine reporters have worked in the bureau – Eric Tucker, David Klepper, Erika Niedowski, to name a few – and AP used to have a regular presence at the State House during the legislative session. More recently, the focus has shifted to broader stories. Smith tweeted that she started in the Providence bureau in 2005 (and her work on a PBS Frontline documentary is highly recommended). Lauren Easton, VP of corporate communications for AP, tells me via email: “Our Providence staff will work in the field and from home when we close our physical office there. AP is not reducing its footprint in Rhode Island or any other state.”

CIRCULAR ARGUMENT: Are traffic circles, aka rotaries, beyond the skillset of Rhode Island drivers, does RI DOT bear responsibility, or is the ruckus about the new rotary off the Henderson Bridge in East Providence something that will sort itself out over time? As an EP denizen, I’ve driven through the rotary multiple times without incident since it opened, but this has happened at off-hours with minimal traffic. Other motorists have had less pleasant experiences. “What fresh hell is the new Red Bridge interchange,” fumed former ProJo reporter Linda Borg on Facebook. “I went around twice, wound up back on the East Side and, counter to the signs, took the lane that said 195 west. The sign should have said, WTF, because that’s how badly this circle was designed.” Research suggests roundabouts are a benefit for safety, even though they remain uncommon in the U.S. Meanwhile, a proposed roundabout in Portsmouth is encountering stiff opposition, as WPRI reported.

TAKES OF THE WEEK: A mix of views from various Rhode Islanders.

ALEX RANDO, chairman of Rhode Island Young Republicans: “The mission statement for the Rhode Island Young Republicans is to, recruit, train, and elect the future generation of Republican leaders. Right now, we are focused on fundraising and recruiting candidates in areas we feel we can win, such as, West Warwick, Warwick, Cranston, Woonsocket, Smithfield, Cumberland, Lincoln and Johnston. Whether it is physical volunteers or financial support, we look forward to supporting our candidates. We will be having a series of monthly networking events around the state, and our first event will be on December 14, 6 pm at the Centredale Revival in North Providence.”

Physician, community activist and OG of Latino politics Pablo Rodriguez: “If you break your arm, you don't just cut it off. You put a cast on and fix the fracture. When it comes to immigration, a system we all acknowledge is broken, we are looking to fix it by cutting off an ‘arm’ that the National Academy of Sciences categorized as ‘integral to the nation's economic growth.’ Worse, we are using a national security emergency in Ukraine and Israel to fuel the chainsaw. The images of thousands of immigrants coming to the southern border and of cities overrun with bused-in asylum-seekers are driving politicians to an erroneous conclusion that more enforcement is the answer. Donald Trump is already promising the largest deportation wave in U.S. history. We will spend billions on bigger walls and deportation forces only to hurt our economy and our future, without appreciably stemming the need for people to escape life-threatening circumstances. Securing the border can only be achieved by changing the circumstances that make people take the treacherous trip to the US, and by improving the system that allows for the adjudication of asylum claims, thereby eliminating the current loophole that keeps people in limbo for years. We also need to recognize that we need more, not fewer, immigrants if we are to thrive as a country. Our fertility rate has fallen below replacement level, and without an influx of young people, we will not be able to keep up with the needs of an aging population. According to FWD.us projections, the U.S. should double immigration levels to remain competitive and keep fiscal programs like Social Security strong. International migrants were the sole source of growth in the U.S. working-age population in 2021 and 2022. Without the growth among the foreign-born, the total working-age population would have fallen by almost 0.5%in 2021. In total, foreign-born workers account for almost half of U.S. employment growth from January 2021 through May 2023. But aren't immigrants taking away jobs from citizens? In early 2023, the share of working-age U.S. natives who were employed surpassed its pre-pandemic rate and reached a 20-year high. We have too many jobs and not enough people. The answer is not more barriers, but easier paths to legal entry and work. We need to fix the fracture, not cut off the arm.”

CORTNEY NICOLATO, president/CEO of the United Way of Rhode Island: “This week, Blue Cross & Blue Shield of R.I. and the Brown University School of Public Health released their 2023 Rhode Island Life Index. Its findings …. were not good. In fact, the report, which measures Rhode Islanders’ perceptions on quality of life issues here in the Ocean State, saw its lowest score ever: 58. If this were a test, our state would get an F. It should surprise no one that our lack of affordable housing was a major factor in the failing grade. Even more concerning is that two-thirds of index respondents consider housing costs out of reach. This begs the question: is Rhode Island’s housing crisis even worse than we think? It very well could be, and that should frighten all of us who call this great state home. The time has come to push our leadership and ask what’s happened to the ‘historic’ $250 million investment lauded in August 2022. Yes, housing is an issue nationwide, but here, where we have the country’s oldest housing stock and lag far behind neighboring states in new housing construction, it threatens our ability to move forward. The clock is close to striking midnight, and we need 2024 to bring what 2023 did not: more action.”

KICKER: The ownership of the Red Sox certainly came through for the Fenway Faithful, helping end an 86-year drought with the remarkable World Series run in 2004, not to mention additional championships in 2007, 2013 and 2018. More recently, though, fortunes have taken a turn for the worse in Sox Nation, with ownership seeming disinterested and unwilling to make even proactive investments in the roster. Now comes news that Larry Lucchino, part of the original group that bought the Sox more than 20 years ago, appears poised to cash in with the sale of the WooSox. “I’m now 78, I’ve been at this for over 40 years, so it’s time to sell this team and move on to blissful retirement,” Lucchino told podcast hosts, as reported by the Globe. Well, that may be well and good. But how about some return on investment for all the emotion and dollars invested by Sox fans? 

Ian Donnis can be reached at idonnis@thepublicsradio.org

Donnis, politics, medical


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