R.I. health-care leaders celebrate improvements, cost savings statewide

Health-care leaders gathered on Thursday to celebrate strides that Rhode Island has made in improving primary care, namely the spread of doctor's offices called "patient-centered medical homes" — soon to be expanded to pediatric practices. 

But they said that Rhode Island still has a long way to go to make health care more affordable and to better coordinate care between primary physicians, behavioral experts, specialists and hospitals. 

A few dozen people turned out at the Rhode island Foundation for the fourth annual meeting of the Care Transformation Collaborative, which was founded in 2008. The group receives funding from the state and insurers to spur the growth of patient-centered medical homes, which are seen as a way of reducing costs by emphasizing prevention and wellness. 

There are now 73 such medical homes with 400 care providers in the state providing care to nearly 300,000 Rhode Islanders, nearly one-third of the state, said Debra Hurwitz, co-director of the collaborative. 

"Our goal is to continue to expand that reach so that ultimately every Rhode Islander has access to a high-performing patient-centered medical home," Hurwitz said. 

Her organization recently incorporated as a nonprofit and changed its name from the R.I. Chronic Care Sustainability Initiative.

"We now have a 19-member board of directors, and in order to achieve our goals of improving quality, affordability, reducing costs and improving population health, we've changed the name a little bit," she said. "It's not a shift away from primary care, but it's kind of an expansion to working more closely with an integrated system of care. So primary care connecting to hospitals, specialists and community-based services and supports. Primary care can't do it alone. These objectives and the goals are gigantic and we already have to all work together. So the name of the organization was changed."

In its annual report, the collaborative reports improvements in patient care in several areas, including an increase to 70 percent of diabetes patients controlling blood glucose levels. Also, total hospital admissions declined 11 percent from 2012-2014 compared with 8 percent for a control group. Meanwhile, emergency room visits have been trending down.

Despite the money being spent by insurers and others in developing patient-centered medical homes, costs have yet to come down satisfactorily.