Primary Care

Screen shot / Centers for Medicare and Medicaid

The Centers for Medicare and Medicaid have announced the second round of Health Care Innovation awards. These are big grants for projects that are trying to reduce the cost of health care and/or improve care delivery, often for some of the sickest or most complicated patients.

The state’s largest hospital chain and largest insurer have inked an agreement to share patient data that will help them look for ways to improve health and save money. The deal is the largest of its kind in the state and could shape health care for more than 35,000 Rhode Islanders.

A statewide effort to link more Rhode Islanders with primary care is expanding.

The effort is called the Chronic Care Sustainability Initiative, or CSI.CSI promotes the patient-centered medical home model of health care. In a patient centered medical home, a team of health care professionals coordinates a patient’s care. It’s especially helpful for patients with chronic illnesses, although anyone can join.

State officials have announced another tool to help physicians spot and treat drug abuse.

The Rhode Island Department of Health's recent decision to grant approval, with 22 conditions, to CVS to open seven retail health clinics in pharmacies throughout Rhode Island came down in the form of a 43-page document. In my humble opinion, it's a well-written, even eloquent ode to the importance of primary care and the challenges of regulating health care in a state where for-profit health care is no longer around the corner but setting up shop on it.

Megan Hall / RIPR

The nation’s largest pharmacy chain has been given the green light to open seven retail health care clinics in Rhode Island. CVS pharmacies’ MinuteClinics would see patients for minor illnesses and perform some routine health screenings. But state health officials' approval comes with several conditions.

As you may know, far more Rhode Islanders signed up for Medicaid than expected recently. And the state is on the hook for millions more dollars than anticipated to care for them. The federal government is picking up the tab for now for people who became newly eligible for the program under the Obamacare Medicaid expansion, which Rhode Island opted to accept (unlike some other states). That allowed childless adults, men and women, earning less than a certain amount a year, to get health insurance, some perhaps for the first time.

Having a chronic disease like diabetes or asthma can be debilitating. It can also be managed with ongoing medical treatment and taking care of your health. But there's a cost to not managing these conditions - to your health, and to the health care system. That's why health care professionals and public officials have been focusing their efforts on helping patients manage those chronic conditions through better primary care. That's the goal of the "chronic care sustainability initiative" in Rhode Island, or CSI  RI.

David Orenstein / Brown University

Match Day was Friday for fourth year medical students around the country. It's an annual rite, the moment when students find out whether and where they'll be doing their residency. It's a big deal because where you do your residency matters on so many levels - from the number of years you'll spend there, to the quality of the doctors who train you, to the opportunities you'll have to deepen your specialty. And many residents end up staying where they train.

Another study seems to suggest that, contrary to previous assumptions, it does.

Researchers from Beth Israel Deaconess Medical Center in Boston have just published the results of a study in the Annals of Emergency Medicine that looked at all emergency department visits at 69 hospitals between the fall of 2006 and the fall of 2009. In 2006, Massachusetts expanded access to health insurance to nearly everyone in the state.

News from the state's health insurance commissioner (OHIC): insurers are making good on their commitment to invest more of their premium revenue in primary care. OHIC directed insurers to raise the amount they spend on their members' primary care by one percentage point every year for four years. And in a new report the agency says they're going to hit those targets.

Rhode Island Department of Health

I had a chance to speak to Department of Health director Dr. Michael Fine this morning as he traveled to a conference in Boston. The gathering, put on by the Lown Institute, is "From Avoidable Care to Right Care," convenes "...clinicians, patient advocates, and civic leaders to deepen our mutual understanding of the cultural, scientific, and ethical issues surrounding the overuse of medical services." (Dr.

Senator Sheldon Whitehouse

Senator Sheldon Whitehouse will hold a roundtable discussion Monday on how the Affordable Care Act is benefiting the state. He hopes to call attention to efforts to reduce costs and improve quality.

Association of American Medical Colleges

The Association of American Medical Colleges (AAMC) has released state-by-state profiles of the physician workforce for 2012. And in Rhode Island, here are the highlights (see the full profile here):

Kristin Gourlay / RIPR

California-based Prime Healthcare Services won approval earlier this week to buy Woonsocket’s Landmark Medical Center. But the approval came with conditions. One is that the company keep Rhode Island regulators abreast of a federal investigation it’s under for allegedly over-billing Medicare. Another is that Prime invest in primary care and in preventing hospital re-admissions. The Department of Health expressed some concern about Prime’s practices at other hospitals, but department head Michael Fine said the terms of the deal to acquire Landmark should allay those concerns.