Medicaid

The head of HealthSourceRI is stepping down to become director of Medicaid. Anya Rader Wallack starts her new job on Monday.

Former Medicaid Director Deidre Gifford announced her resignation in September. Anya Rader Wallack will take her place on November second. That makes her tenure as head of HealthSource RI, the state’s health insurance marketplace just shy of a year.

Kristin Gourlay / RIPR

Medicaid officials testified Monday before House and Senate fiscal advisers about how much they expect to spend on medical assistance for the poor in Rhode Island. Officials expect a small deficit and growing enrollment.

Twice a year, Medicaid officials report how much they’ve spent and what they think they’ll spend in the coming fiscal year. It’s part of the budget process. Highlights from Monday’s testimony include a projected deficit of $5.7 million dollars for this fiscal year. That’s tiny compared to total Medicaid spending, projected to be about $2.3 billion dollars.

Kristin Gourlay / RIPR

Rhode Island’s Medicaid director, Dr. Deidre Gifford, is stepping down. A search for her replacement is underway.

From the Annals of Internal Medicine article: Restrictions for Medicaid Reimbursement of Sofosbuvir for the Treatment of Hepatitis C Virus Infection in the United States / Authors: Soumitri Barua; Robert Greenwald, JD; Jason Grebely, PhD; Gregory J. Dore, MBBS, PhD; Tracy Swan; and Lynn E. Taylor, MD

Hepatitis C may not take as big of a chunk out of the state’s Medicaid budget as previously projected. One reason? A majority of patients who requested treatment have been denied.

Rhode Island has been given the green light for a pilot program to coordinate health care for people enrolled in both Medicare and Medicaid. They're known as “dual eligibles” and have to navigate two complex systems to get the care they need.

Kristin Gourlay / RIPR

Governor Gina Raimondo has asked a working group to come up with a way to slow health care spending in Rhode Island. It's a strategy that has showed promise in Massachusetts.

Raimondo signed an executive order to establish the Working Group for Health Care Innovation. The group’s charge is to propose a way to limit the growth in public and private health care spending. One model might be close to home. Raimondo says Massachusetts placed a cap on spending.

Kristin Gourlay / RIPR

The future of health care for the poor, a review of Rhode Island’s criminal justice system, and politicking in Vermont…that’s part of the conversation this week on Political Roundtable. Rhode Island Public Radio’s Kristin Gourlay hosts; Ian Donnis is away. We're joined, as always, by URI political science professor Maureen Moakley and RIPR's political analyst Scott MacKay.

Thanks for stopping by. It's been a long week, so let's get rolling before I fall asleep at my standing desk. Your tips and thoughts remain welcome at idonnis (at) ripr (dot) org, and I invite your attention on the twitters. Here we go.

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House lawmakers will vote next week on an $8.7 billion dollar state budget. More than a third of it pays for health care and other related services. Rhode Island Public Radio’s Kristin Gourlay joined host Dave Fallon in the studio to walk through some of the highlights. Listen to the audio or read a transcript of their conversation, below.

DAVE: Kristin, welcome. So a major centerpiece of the budget is Governor Gina Raimondo’s plan to quote “Reinvent Medicaid.” Recap for us what that’s about and tell us, did she get what she wanted?

RIPR FILE

House lawmakers have voted to pass an $8.7 billion dollar budget that restores some proposed cuts and adds money for education and economic development.

House finance committee members voted to include many of Governor Gina Raimondo’s proposals to streamline Medicaid and spur business and job growth.  But the budget that now heads to the full House for a vote is $37 million dollars richer than her original ask, thanks to a rosier state revenue picture. House fiscal advisor Sharon Reynolds Ferland gave lawmakers the bottom line.

Rhode Island’s largest health care network will close six group homes by the end of August. Lifespan affiliate, Gateway Healthcare, blames reimbursement rates for the closures.

The closures will affect dozens of adults with substance abuse or mental health diagnoses, and a little more than a dozen kids in state care. They range in age from five to 18. Gateway says Medicaid doesn’t pay enough to cover the cost of their care. Executive office of health and human services secretary Elizabeth Roberts acknowledges that’s a challenge.

Neighborhood Health Plan of Rhode Island, which manages thousands of the state’s Medicaid patients, has found a way to bring down health costs for some of its highest need patients. The organization’s chief medical officer Paco Trilla says the Health@Home program targeted about 450 patients with multiple chronic conditions. They were using a lot of medical services, but not getting better.                

On Tuesday, two Rhode Island House committees will take another close look at Governor Gina Raimondo’s proposed budgets for Medicaid and the state’s health and human services agency. The Senate heard similar proposals last week.

The hearings offer another opportunity for public testimony and committee members’ questions before the budgets hit the full House and Senate for consideration.

Ian Donnis/File Photo / RIPR

Physician, educator and talk-show host Pablo Rodriguez joins Political Roundtable this week to discuss the uptick in state revenue; the battle over Medicaid spending; whether lawmakers have done enough to respond to the misuse of campaign contributions; and the PawSox.

Health care workers rallied at the Rhode Island Statehouse today to call for better wages. The Service Employees International Union has concerns about budget cuts for Medicaid.

The union represents about 4000 nurses, CNAs, and service employees who work in nursing homes and hospitals. The union has issued a list of proposals it says could help the state trim millions of dollars from Medicaid and boost pay for low wage workers.

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