Highlight on Rhode Island: Wave of health care innovations in Ocean State

The smallest state in America is working to improve its residents’ health through a number of new initiatives. From a pilot program that will provide children with access to behavioral health care in their schools to new programs to compile large-scale data on public health and insurance claims, these innovative projects will enable Rhode Island to track and improve health care.

School behavioral health initiative

Providence Public Schools, The Providence Center, and Behavioral Health Solutions are partnering in a program that will put behavioral health clinicians in two elementary and four middle schools. Rhode Island has a shortage of child behavioral health providers, and  most child psychologists in the state don’t accept insurance, leaving children in the state at risk. The public-private initiative will make it easier for public school children to receive necessary services.  The program will make care more accessible, with specialists on-site and available during school hours, and will allow teachers and principals to directly refer students for help quickly. Clinicians will not bill the school system, but rather will charge the students’ health insurance, including Medicaid and the Children’s Health Insurance Program, for services provided. Providence Mayor Jorge Elorza hopes this initiative will be the first step in providing behavioral health services to all area students in need. The program began with a pilot at West Elementary School, which has made counseling and referral services available to 44 students.

Pilot public health dashboard

Providence was chosen as one of four cities to participate in the Municipal Health Data for American Cities Initiative, launched by the National Resource Center and part of the White House Initiative on Strong Cities, Strong Communities. Providence residents face health challenges that include high chronic disease and related risk factor burdens. Low-income residents and communities of color are disproportionately affected. Providence will employ population-based strategies focusing on high-risk, vulnerable groups to expand the reach and health impact of improvements across sectors. Although it is not yet clear what data will be available through the dashboard, the initiative will frame federal and county data at the municipal level, extract key benchmarks that are embedded in existing city-level data, and create entirely new indicators through big data and social media activity. Elorza hopes to use the dashboard to see where Providence ranks among other cities in New England with regard to the city’s health levels, and then improve to be one of the fittest cities in the region. The other cities chosen to participate are Flint, Michigan; Waco, Texas; and Kansas City, Kansas.

All-payer claims database

Rhode Island recently launched the HealthFacts RI Database, an all-payer claims database that provides medical and pharmacy claims data from all private and public health insurers and administrators in the state, and the most comprehensive collection of health care claims data that the state has ever compiled. The database is intended to help state agencies and researchers learn where health care dollars are going, how effective various uses of dollars are, and track overall trends. It includes data from nearly 825,000 Rhode Islanders–using what the state calls “extensive precautions” to protect patient privacy –with claims totaling $18 billion between 2011 and 2014. Rhode Island is one of 18 states with such all-payer claims databases, though the Supreme Court’s recent decision in Gobeille v. Liberty Mutual Insurance Company makes it more difficult for states to require some plans to report data. The Gobeille Court found that the Employee Retirement Income Security Act (ERISA) preempts Vermont’s law requiring insurers to participate in that state’s all-payer claims database.