Catalyst for Payment Reform

Patrick Tigue on Rhode Island’s Regulatory Strategy to Contain Health Care Costs

Patrick Tigue on Rhode Island’s Regulatory Strategy to Contain Health Care Costs

Suzanne calls Patrick Tigue, the Health Insurance Commissioner and former Medicaid Director of the state of Rhode Island. They discuss the Office of the Health Insurance Commissioner (OHIC)’s initiatives to stem health care cost growth in the state. 

Rhode Island established a cost growth benchmarking process to bring greater transparency to the market in 2018. The state also has a first-in-the-nation regulation that caps annual growth in prices paid by commercial health plans, established in 2010. A 2019 study in Health Affairs analyzing Rhode Island’s health care spending from 2007-2016 found that these price caps, known as affordability standards, led to a 8.1% decline in quarterly spending. Patrick and Suzanne chat about how Rhode Island’s affordability standards address the root cause of health care cost growth, and what may be ahead for Rhode Island and other states that follow its lead. 

This episode was recorded in April 2021, a few days before OHIC released the results of the state’s performance against the cost-growth target for calendar year 2019 – the first year of its implementation. Click here to read media coverage of the results. Spoiler: the state, unfortunately, was not able to meet its target for that year. According to a prepared statement by Patrick Tigue on the results, the state still has work to do to lower health care cost growth and improve affordability for Rhode Islanders.

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