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Rhode Island Medicaid now pays more for primary fee-for-service care than most of New England

Health Insurance Commissioner Cory King and Governor McKee. Credit: Ian Donnis/Ocean State Media
Health Insurance Commissioner Cory King and Governor McKee. Credit: Ian Donnis/Ocean State Media

McKee hopes to propose another $16.5 million for Medicaid payments as the state tries to become more competitive in attracting physicians

A new report from the state Office of Health Insurance Commissioner shows that Rhode Island has enhanced its standing among New England states on Medicaid reimbursement for primary care.

Fee-for-service rates for Medicaid, the insurance program for low-income residents, are now higher in Rhode Island than Massachusetts, Connecticut, Maine and New Hampshire, the report shows.

If he wins re-election, Gov. Dan McKee said he will build on that progress by directing $16.5 million in state and federal funds in his next state budget to make Medicaid reimbursement for primary care closer to the actual cost of care.

“That means more resources for provider recruitment and more capacity to serve patients,” McKee said during a Statehouse news conference Tuesday.

Democratic primary voters will decide next Wednesday between McKee and Helena Foulkes, who has also vowed to improve reimbursement for healthcare costs in the state.

Two-thirds of healthcare costs in Rhode Island are paid through public insurance programs – Medicaid and Medicare – while just one third is paid through private insurance.

That dynamic can make it harder for Rhode Island to attract and retain primary care doctors, particularly when physicians can earn more practicing in Connecticut or Massachusetts.

McKee looks to build on reimbursement gains

McKee pointed to Rhode Island’s improved standing on Medicaid reimbursement for primary care as evidence of progress. He said the gains build on the state’s boosting of Medicaid reimbursement rates for primary care last October.

If the additional $16.5 million is invested in the state’s Medicaid program next year, he said, it will make Rhode Island a leader in primary care and make it easier to attract doctors to the state.

Medicare and private insurance remain challenges

McKee acknowledged that changing Medicare reimbursement is difficult because it is a federally administered program, and he noted that Rhode Island’s Medicare rates are lower than those in Connecticut and Massachusetts. The governor said he will send a letter to the state’s congressional delegation, encouraging them to make this a top priority.

Changing the reimbursement for private insurance is also challenging.

Asked how the improvement in Medicaid reimbursement will affect the mix of healthcare payers in Rhode Island, state Health Insurance Commissioner Cory King said McKee’s recommendation “will give us a competitive edge relative to other states.”

Ian Donnis has reported on Rhode Island politics since 1999, when he arrived in the state two weeks before the FBI raided City Hall and Buddy Cianci’s East Side home. Subscribe to his weekly political newsletter here.

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Federal funding is gone.

Congress has eliminated all funding for public media.

That means $2.1 million per year that Connecticut Public relied on to deliver you news, information, and entertainment programs you enjoyed is gone.

The future of public media is in your hands.

All donations are appreciated, but we ask in this moment you consider starting a monthly gift as a Sustainer to help replace what’s been lost.

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