Category Archives: Health Care

Hospital Readmission rates and the impact on the cost of health care.

Those who have followed the changes in health care brought on by the Patient Portability and Affordable Care Act (ACA), know that there is an emphasis on reducing the rates of readmission to hospitals.  Recently, Kaiser Health News published a report about a study of these rates countrywide.

Of interest to us is the readmission rate in Rhode Island. Four hospitals were identified as having rates higher than the national average while others were at or about at the national average. Click here for the story.

This begs a fundamental question: What exactly constitutes the health care required to tamp down the rates of readmission?  Is it merely traditional medical services where all the providers of care are obvious and well known?  Or is it something more, where non-medical resources, such as lawyers, social workers, and case managers, can be brought on as a part of the medical team to address the non-medical social determinants that impact health outcomes?

As  the legal partner of the Rhode Island Medical-Legal Partnership, I assert  that it’s the latter.  Remediation of unhealthy conditions, such as unhealthy housing along with food and income insecurity can have a direct positive impact on health outcomes, which in turn can work to reduce some of the higher levels of hospital readmission rates.

In short, what that report shows and the ACA demands is that we think about health care in an entirely new and expansive way.

Rhode Island Health Care Project – Special Alert November 18, 2013

RI Health Care Project

6,000 Parents Losing RIte Care:
What is Happening and How to Help Them

The budget passed by the General Assembly in June included a provision that the RIte Care eligibility limit for parents would be “rolled back” from 175% FPL ($34,177 for a family of 3) to 138% FPL ($26,951) on December 31, 2013. The expectation was that parents who were dropped from RIte Care would enroll in commercial coverage offered through HealthSource RI, the new health insurance market place.
Children enrolled in RIte Care will keep their coverage – there is no change in the income limit for children. And beginning January 2014, families will no longer need to pay a monthly premium to keep their children enrolled.
What is happening: On November 15, the Executive Office of Health and Human Services (EOHHS) began the process of putting the “roll back” of parent eligibility into effect.
First, EOHHS must give parents the opportunity to show that they are still eligible for RIte Care. Parents may be eligible if income is below the limit (because income has dropped or the family is bigger) or if a parent is pregnant or the parent has a disability. On November 15, EOHHS sent a letter (See Copy Here) to parents telling them about the roll back of eligibility and providing a form for them to fill out to sh
ow they may still be eligible. The form must be returned by EOHHS November 25th. Second, if the parent does not return the form, EOHHS will send the parent a letter around December 2 explaining how the parent can enroll in coverage through HealthSource RI.
Third, EOHHS will send the parent a formal notice around December 20th stating that their RIte Care coverage will end on December 31st.
This Chart (prepared by EOHHS) shows these steps and the advice to give parents at each step.

How to help parents:

  1. Remind parents that children will not lose RIte Care coverage and parents will not have to pay to keep them enrolled.
  2. Help the parent complete the form from EOHHS if it applies to them and return it to EOHHS by November 25th.
  3. Parents can get help enrolling in a new health care plan through HealthSource RI and financial help will be available to help them buy coverage. They will receive more information about this soon.
The Rhode Island Health Coverage Project, an initiative of The Economic Progress Institute and Rhode Island KIDS COUNT, works to ensure that the consumer voice is present as the state makes decisions about health care reform. Read more…