RI’s Healthcare System Has Never Faced More Challenges - Closures and Bankruptcies Hammer Industry
GoLocalProv News Team
RI’s Healthcare System Has Never Faced More Challenges - Closures and Bankruptcies Hammer Industry
Make no mistake about it, healthcare in Rhode Island is big business and one of the largest employers.
GET THE LATEST BREAKING NEWS HERE -- SIGN UP FOR GOLOCAL FREE DAILY EBLASTAnd now, maybe at a higher level than ever before, Rhode Island’s healthcare system and its very foundation — the primary care system — is in significant distress.
In recent months:
- Thundermist Health Center announced it is laying off 124 of its 907 employees. The health center has offices around Rhode Island and serves more than 60,000 residents.
- CharterCARE’s parent company is in bankruptcy. It is the state’s third-largest hospital system, which operates Roger Williams and Fatima hospitals, and is moving towards being acquired by a Georgia healthcare company. That company is attempting to sell $165 million in bonds to finance the deal. And according to financial documents, CharterCARE has lost more than $130 million over the past five years of available financials — 2019 to 2023. In 2023, CharterCARE lost $60 million alone. The total cost of the bonds with debt service exceeds $400 million.
- Anchor Medical Associates, the primary care physician group, announced it would close its offices across the state at the end of June, leaving 25,000 Rhode Islanders without primary care physician services.
- Potentially more disruptive are the changes being made at the federal level by the Trump administration. The ties between Brown University and Lifespan (now Brown Health) are now under the microscope by the Trump administration.
As GoLocal was first to report, the Trump administration “clawed back” $31 million of federal funds from the Rhode Island Department of Health (RIDOH).
Following that, millions of dollars in federal grants awarded by the National Institute of Health (NIH) to the University of Rhode Island, Rhode Island Hospital, and Brown University are being slashed.
The Trump Administration is also reportedly pausing $510 million in federal funding to Brown and has multiple investigations into the school relating to antisemitism.
“Healthcare in Rhode Island is under tremendous stress, ranging from the hospital systems to primary care. I spent a lot of time looking into this and at the end of the day, I think that the biggest issue is that Rhode Island is a small state, we have less funding compared to a lot of states we have fewer insurers, fewer payers, and this just creates a ripple effect across our state where we just have less money going into health care especially compared to other states,” said Dr. Chan, in an interview on GoLocal LIVE.
SEE THE FULL INTERVIEW BELOW
Dr. Larkin said, "The shortage of primary care clinicians is a national issue. Almost every state is grappling with this problem. The Association of American Medical Colleges estimates that a national physician shortage of up to 86,000 physicians could exist by 2036. People use different methodologies to measure the need for additional primary care doctors in individual states. Some complicating factors are that healthcare professionals have patient panels of different sizes, and people’s specialties are not always perfect indicators of the care they provide. (For example, an OBGYN who provides holistic care to patients may be doing primary care. Other OBGYNs provide more specialized care.) Another factor is that much primary care comes from nurse practitioners and physician assistants."
“A recent study conducted by Manatt Health reported that Rhode Island had fewer primary care physicians per 100,000 than Massachusetts but more PCPs per population than Connecticut. Rhode Island had 122 primary care physicians per 100,000 population, compared to 136 primary care physicians per 100,000 in Massachusetts and 108 primary care physicians per 100,000 in Connecticut. With the passage of the Rhode Island Healthcare Workforce Data Collection Act last year, we will be able to use the licensure and renewal process to better assess our healthcare workforce needs,” added Dr. Larkin.
“Primary care is really the front line and the foundation of the health care system in this country. It's really, really important that we have a strong primary care system not just in Rhode Island but across the United States,” added Dr. Chan.
“The estimates here in Rhode Island are that we're anywhere from 100 to 300 primary care providers short of where we need to be to really provide adequate primary care to the state,” said Dr. Chan.
Could a Medical School at the University of Rhode Island Help to Solve the Problem
There is a study commission in Rhode Island now looking at the benefits, costs, and challenges of establishing a medical school housed at the University of Rhode Island. Both Connecticut and Massachusetts have highly successful state-sponsored medical schools.
“The opening of any new medical school is complex and time-consuming. While expanded training opportunities are always worth exploring, the State is focused on other shorter-term strategies to address the need for primary care,” said Dr. Larkin.
Dr. Chan is more positive about the idea.
"In July of 2024, the state did form a state commission to look at this. They're looking at how to improve and retain our healthcare workforce, and importantly, they're also looking at a medical school at the University of Rhode Island, something that I'm personally a supporter of. I think that would be a big boon to Rhode Islanders, so we're looking forward to their reports in the coming months,” said Dr. Chan.
Dr. Larkin said that the state is moving forward with a number of initiatives.
“As he had proposed in last year’s recommended budget, this year the Governor again recommended that primary care provider reimbursement rates be reviewed by the Office of the Health Insurance Commissioner as part of its biennial evaluation. This would position the state to thoughtfully increase those rates as a long-term sustainable solution,” said Dr. Larkin.
“Last month, Rhode Island's Office of the Health Insurance Commissioner implemented new regulations aimed at strengthening primary care. These regulations require commercial insurers to incrementally increase funding for primary care services over a four-year period, with the goal of doubling per-member primary care spending by 2029. Additionally, the regulations mandate a 20% reduction in prior authorization requirements, thereby reducing administrative burdens on providers. These measures are designed to enhance financial support for primary care practices, improve access to necessary treatments, and allow providers to focus more on patient care, ultimately contributing to a more efficient and effective healthcare system in Rhode Island,” said Dr. Larkin.
He added that three other initiatives are in motion.
- Governor McKee also proposed new investments in RIDOH’s Health Professional Loan Repayment Program—marking the first time since Fiscal Year 2008 that general revenue would support the initiative. Under this program, participating health professionals commit to working for at least two years in Rhode Island.
- We announced last month that the State will be making up to $90,000 in grant funding available to numerous primary care sites to support their work to train more students and mentor Rhode Island’s next generation of physicians, nurse practitioners, and physician assistants. This program at RIDOH is being supported by $2.7 million in State General Revenue funding.
- To take a holistic approach to this issue, the Governor created the Health Care System Planning Cabinet to assess the state’s healthcare system, address cross-cutting challenges, and build a cohesive roadmap for long-term system sustainability. One of the Cabinet's first recommendations is implementing a mechanism to help strengthen fiscal oversight of Rhode Island’s health care system, which would enable the state to monitor financial solvency and engage in timely problem-solving. We expect to have more on this in the coming days.
But presently, despite the initiatives, the fragile healthcare system is under more financial stress, seeing more closures and bankruptcies than ever.