Care coordination stressed at health listening session

Kelcy Dolan
Posted 9/24/15

There was cry for care coordination at last Tuesday’s healthcare listening session.

While discussion ranged from preventative and mental healthcare, the complexity of insurance and the …

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Care coordination stressed at health listening session

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There was cry for care coordination at last Tuesday’s healthcare listening session.

While discussion ranged from preventative and mental healthcare, the complexity of insurance and the coordination, or lack thereof with care, those speaking were upset that there seems to be a disconnect between state’s healthcare system and patients.

Nearly 50 people attended the first listening session for Governor Gina Raimondo’s Working Group for Healthcare Innovation at the Buttonwoods Community Center. Those in attendance for the meeting hosted by Mayor Scott Avedisian and Rhode Island Secretary of Health and Human Services, Elizabeth Roberts represented small business owners, health care providers, insurers, legislators past and present and working group members.

The public was invited to share their experiences with the healthcare system and how they would like to see the system change.

Roberts said that health is an essential part of a happy life and necessary for a stronger Rhode Island.

The goals of the working group is to make recommendations to the governor, by December 1 of this year, on ways to reduce per capita costs for healthcare, improving a patients quality of care and satisfaction and improve the overall health of the state’s population.

Avedisian admitted that when he was first asked to be a part of the working group he was apprehensive, having been on similar boards and seeing nothing come from them but was excited to see Raimondo had actually set forth an “ambitious” schedule.

“We are set on getting the job done and accomplishing something here,” he said.

Those few who came forward to speak were concerned mainly with the coordination of care, transparency and accessibility of the system, as well as the affordability of healthcare for both individuals and businesses.

Stephen Boyle, president of the Greater Cranston Chamber of Commerce, said that it is becoming harder for small businesses to keep up with the increasing cost of healthcare. Continuously having to adjust rates is frustrating and he would applaud any effort to try and control costs in the state.

Roberts, in a short presentation preceding public comment, noted that as of 2009 Rhode Island was spending 22 percent more than the national average on healthcare. She said that part of that cost is the aging population of Rhode Island, and that means more expensive care.

Boyle also wants to see costs for treatments, procedures and tests to be standardized so patients can at least be aware of what to expect no matter where they are getting their care.

Part of the problem, in Joanne McGunagle’s opinion, is that “insurance companies are dictating care.” She said that when insurance companies are covering one prescription over the other, one type of surgery over another, patients are faced to make decisions on what they can afford, not what may be best for them.

Donna Castricone, a registered dietician with the Rhode Island Academy of Nutrition & Dietetics, said a lack of reimbursement from insurance companies for preventative care is also a concern. She believes one goal should be to keep people healthy, not just getting them healthy after an illness or condition. She exampled someone at risk for diabetes, when many insurance companies won’t cover services from a nutritionist or dietician but then have programs for diabetics.

“It can be cheaper on everyone to prevent those conditions we can,” she said. “Provide people with incentives for measurable goals, getting their cholesterol checked, visiting a nutritionist or dietician.”

Mental healthcare was the concern of Tina Spears, the government relations director for the Rhode Island Parent Information Network.

“We need to treat the patient holistically,” she said. “We need to include the mind with the body when we are talking about someone’s health.”

She said that for many families with an individual suffering from an emotional, behavioral or mental health issue it has become almost a “crisis situation” trying to find proper care.

Spears has a child with a condition and she jumps from specialist to specialist because of a lack of care coordination.

Roberts herself stressed the need to improve care coordination and shared a story of her own when her husband was ill. They visited one hospital and he was discharged, but when the condition only worsened the next day she and her husband went to another hospital. He was in a hospital bed when he received a call on his cell phone from the initial hospital saying he had tested positive for Lyme disease.

“That hospital had no idea he had been admitted again. We need a better support structure for the ill,” she said.

At the end of the listening session Avedisian asked the audience how many had the personal numbers for their primary care physician and only about five people raised their hands.

“This is part of the issue, too. Healthcare today is less personal than it used to be,” he said.

There will be a second listening session also hosted by Roberts and Director of Health Nicole Alexander-Scott, MD, MPH on Tuesday, October 13 at 6 p.m. at the Juanita Sanchez Educational Complex in Providence.

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