Raimondo Announces Formation of Working Group to Reinvent Medicaid in RI
GoLocalProv News Team
Raimondo Announces Formation of Working Group to Reinvent Medicaid in RI
Stating that a "healthy economy starts with healthy people," Raimondo said at press conference at the State House on Tuesday that the effort, led by a twenty-eight member group (see list below) representing state healthcare and community leaders, would be comprehensive.
"Cuts, that's not what this is about, " said Raimondo. "It's about tough discussions to look at short term cost savings but long term delivery system changes to yield long term reform and better outcomes."
GET THE LATEST BREAKING NEWS HERE -- SIGN UP FOR GOLOCAL FREE DAILY EBLASTCiting such statistics that Rhode Island has the second highest cost per enrollee in the country - and 7% of patients who are the most expensive represents two-thirds of the cost of Medicaid to the state, Raimondo said however that nothing was "off the table" as far what the group could propose.
"The goal of the group and my goal is to improve quality off care and access to care and coordination of care and substantially reduce costs in process," said Raimondo, ensuring "the most vulnerable among us get the care that they deserve."
Issues to Address
"By April 30, I need I need a recommendation to be submitted as a budget amendment," said Raimondo, as her budget proposal is due to be submitted on March 12. Raimondo added that by July 1, there would be a "second wave for more structural work."
"The budget will be specific with regards to my plans for FY 16 and Medicaid," said Raimondo of what she will put forth in March. "Having said that, some changes are straight forward. Others require negotiation of contracts, changes in systems of care, that's what takes a little bit more time. There will be as much detail as we can provide. Give a complex problem its due, take a little extra time, get all the stakeholders at the table, and do it right."
Raimondo noted the group would be addressing such tactics as "cutting down on abuse," paying for "value not volume," and coordinating healthcare delivery.
"Employers will want to be here if we have talented, healthy workforce, they'll see predictability in our budget, and healthcare spending," said Raimondo.
Secretary of Health and Human Services nominee and former Lieutenant Governor Elizabeth Roberts said on Wednesday that "structural change is difficult, but possible."
"We'll be out at town hall meetings, for providers, caregivers, people there to tell their stories," said Roberts. "There will be short term imperatives that will be particularly challenging, while making sure that we do not forget the needs of the people we are here to serve."
10 Questions Raimondo Has to Answer as Governor
Moving the needle?
Forbes recently ranked Rhode Island 5th worst in the country for business environment -- a not uncommon position for the Ocean State in recent years. Forbes placed RI as high as 20th for quality of life -- but #49 for "regulatory environment."
How soon can Governor-elect Raimondo improve Rhode Island's basement-level assessment and make it more competitive -- and what will she have to do to make that happen? Addressing the sales tax? Estate tax? Look to Raimondo's State of the State address -- and first budget proposal -- for signs as to how the direction the new Governor plans on taking the state.
Gambling hole?
As GoLocal's Stephen Beale pointed out, RI has no plan to deal with $307,000,000 shortfall, when casinos in MA are operational, and RI's third largest source of revenue -- gaming and the Division of Lottery -- will take a huge hit. "A consultant's report showed Rhode Island losing $108.8 million a year in casino gaming revenue by 2017. And that was a best case scenario. The worst case had the state bleeding $158.4 million by 2017," wrote Beale.
How will Governor-elect Raimondo deal with the 800-pound gorilla in the room? Newport Grand failed in its bid for table games on the ballot in November. Will Raimondo let the General Assembly continue to prop up the ailing slots parlor?
RhodeMap RI?
The previously little-known economic development plan under the State's Division of Planning -- made possible by a federal HUD grant -- has heated up in a big way as opponents are voicing their concerns as to the scope and reach of the plan, if incorporated into the state's broader economic plan.
Will Governor-elect Raimondo get behind RhodeMap RI's vision fully, and how would she address detractors who don't appear to be going away at any point soon? Given that there will most likely need to be legislative components to implement the plan, watch to see where Raimondo's leadership is on this issue.
Marijuana legalization?
Some of the air came out of the marijuana legalization balloon when former Speaker of the House Gordon Fox stepped down last year, and the notably more conservative Speaker Nicholas Mattiello took the helm, making the prospect of a marijuana legalization bill appear dim, at best.
The Daily Chronic reported that the Democratic gubernatorial candidates indicated during the campaign that they were "monitoring the effects of regulation and taxation in Colorado and Washington." Raimondo's certainly given no indication she'd be inclined to consider a tax-and-legalize measure, but as gaming revenues start to taper off, will marijuana discussion ramp up as a new revenue option?
Union relations?
While Raimondo appointed five transition team members with big banking ties, she also appointed two union heads -- Pat Quinn with SEIU 1199 and Michael Sabitoni with the RI Building and Construction Trades Council.
While Raimondo managed to secure union endorsements following a primary that saw them go primarily to opponents Angel Taveras and Clay Pell, the legacy of her pension reform still looms large (remember AFSCME famously hired Forbes' Edward Siedle to investigate Raimondo's handling of the state pension fund, namely her move into hedge funds). How will Raimondo negotiate with public sector unions given a past history?
Pension Lawsuit?
What will come of the pension reform lawsuit? While it was quiet leading up to the election following the failed settlement earlier in the year, watch to see the next steps from Raimondo -- and newly elected Treasurer Seth Magaziner (who appointed a fairly union-friendly transition team) to see what attempts may arise to reach a new settlement -- and what implications that may mean for Raimondo, the architect of the landmark 2011 pension overhaul. Depending on the outcome, watch to see how Raimondo's political star rises -- or falls -- from the outcome of the suit -- and how Raimondo addresses the financial implications if a mediated settlement is achieved.
Budget proposal?
All eyes will be on Raimondo's first budget proposal in January. What will her priorities be? Will there be bold moves to improve the state's business climate? Education, infrastructure, tax code -- how will Raimondo choose to tackle the state's biggest issues? And will the Democratic leadership agree with her agenda?
General Assembly?
For the first time since 1991 -- when Governor Bruce Sundlun took office -- a Democrat will be embarking on a gubernatorial administration, and Raimondo will be working with a Democratic legislature. What will Raimondo's working relationship be with Speaker Mattiello and Senate President Paiva-Weed? Will the General Assembly be in lockstep with a Raimondo agenda -- if not, what will the points of contention be? And with a democratic lock on power, what will the Republicans be able to accomplish?
Mandate issue?
Winning the general election to become Rhode Island's first female Governor with 40% of the vote, Raimondo follows in the footsteps of Governor Lincoln Chafee with winning with less that 50% of the vote. Raimondo however has the advantage over her predecessor by being elected as a Democrat, allowing her to work with leadership in the General Assembly. However, with 40% of the vote, how will the public who didn't vote for her view here policies and proposals? Will Raimondo have to win over the public, or will Raimondo take her support from the business community and forge a path regardless?
Transparency?
While General Treasurer, Raimondo came under fire for lack of transparency for the lack of disclosure of hedge fund fees paid for the state's retirement investments, punctuated by Attorney General Peter Kilmartin ruling that Raimondo could keep certain details of the state's investments from the press. Forbes' Edward Siedle wrote, Does [Kilmartin] seriously believe that hedge and private equity billionaires entrusted with state workers retirement savings should be shielded from scrutiny regarding potential violations of law?
While Raimondo will no longer be calling the shots as the head of the State Investment Commission, all eyes will be her decisions in the Governor's office. How transparent with the Raimondo administration be with the press-- and the public?
