Improving the Rhode Island Health Care System

Leveraging the Regulatory Structure Within OHIC to Accelerate Delivery System Reform

The office is focused on improving the health care delivery system in the state to improve affordability, quality, and health equity for all Rhode Islanders. OHIC is supporting delivery system reform by encouraging provider payment models that improve value, fostering primary care transformation, and advising on the impact of hospital consolidation. The goal is to leverage the regulatory structure within OHIC to accelerate the transition to a reformed delivery system where provider organizations are incentivized to deliver accessible, affordable, and high-quality care that produces improved health outcomes.

Advising on the Implications of a Care New England and Lifespan Proposed Merger

In 2021, OHIC released a working paper that reviewed the relevant policy considerations raised by the proposed merger between Care New England and Lifespan entitled, The Care New England and Lifespan Proposed Merger: Policy Considerations Related to the State of Rhode Island Office of the Health Insurance Commissioner’s Statutory Purpose and The Care New England and followed up in 2022 with a second working paper that iterated on and refined three critical payment model structures for the merged entity that would be formed if the proposed merger is approved entitled, The Care New England and Lifespan Proposed Merger: Payment Model Characteristics Necessary to Maximize Affordability and Quality Related to the State of Rhode Island Office of the Health Insurance Commissioner’s Statutory Purpose. Both papers make clear that it is OHIC’s position that the risks to the public interest objectives that guide OHIC’s work—access, affordability, and quality—are significant and should command careful attention by regulators and the public. This is because the available evidence clearly suggests that hospital consolidation leads to higher prices and that the evidence on the impact of hospital consolidation on the quality of care is mixed.

Advanced Access to Doula Services in the Commercial Health Insurance Market

As part of the office's ongoing efforts to accelerate delivery system reform, OHIC advanced access to doula services in the commercial health insurance market in 2021. Improving access to doula services is an important strategy to improve health equity in Rhode Island. OHIC provided technical assistance to stakeholders in support of legislation requiring commercial health insurance coverage to include access to doula services in order to improve perinatal and postpartum outcomes. The office created a quick health insurance coverage guide to help consumers understand whether or not doula benefits are covered by their health insurer, view that guide by clicking here.

Advocating for Legislation that Improves Health Care Affordability 

Consumer protection is a driving principal at the core of all of OHIC's work and advocating on behalf of legislation that makes health care more accessible and affordable for Rhode Islanders is an important aspect of that work. Each week, the office reviews the legislation that has been introduced and is being heard in the General Assembly and testifies in support of bills that help make our health care system more equitable and affordable and against bills that could negatively impact consumers. When possible, OHIC collaborates with members of the General Assembly to help coordinate research, make amendments, and draft legislative language that helps transform the health care delivery system.