PROVIDENCE – Facing mounting public pressure to find a solution to the shortage of primary care in Rhode Island – tens of thousands of patients are with out a doctor after Anchor Medical announced its closure this month – Governor Dan McKee on Tuesday tried to temper concerns around the health care system.
“Rhode Island is ranked better than most states for health care access and quality,” McKee said at a press conference at the State House. “It’s an important point to be making to the general public.”
Yet, nearly 25,000 adult and pediatric patients were informed that their doctor’s office, Anchor Medical Associates, would be shutting down this year. That’s on top of the thousands of patients across the state who were already struggling to find a doctor. Executives at Anchor Medical cited a provider shortage, rising costs, and low reimbursement rates, which have made “it extremely difficult to attract new physicians to our state,” Anchor’s letter to patients said in early April.
In response to Anchor’s impending closure, McKee said he plans to file a budget amendment to accelerate a proposed review of primary care provider rates. Under this review, rate increases, which have been advocated for by patients and health care executives for years, may not be enacted until July 1, 2027, according to Kristen Pono Sousa, the state’s director of Medicaid.
“I don’t think primary care in Rhode Island has two years to wait,” said David Gellis, a primary care physician and the CEO of Arches Medical RI, an independent primary care group with nine locations across Rhode Island.
The governor said a data analysis would need to be completed in order for the state’s Office of the Health Insurance Commissioner to recommend rate increases for primary care providers. However, organizations such as the Rhode Island Foundation, Brown University, and the Hospital Association of Rhode Island have all released data in recent years that show a woeful underinvestment in health care in Rhode Island, as well as low reimbursement rates. When these studies were mentioned Tuesday, McKee pushed back.
“Share the data with us,” said McKee. “I haven’t seen it.”
A comprehensive study by the Rhode Island Foundation last year found that Rhode Island also had the lowest supply of licensed practical nurses, home health and personal care aides, and physician assistants, compared to Connecticut and Massachusetts. In Rhode Island, health care workers are paid less than their peers, the study found.
Even with higher reimbursement rates, patients in neighboring Massachusetts are still traveling out of state to find care, and resorting to inconvenient and expensive ways to access care, such as going to emergency rooms, urgent care clinics, or concierge medicine services. Others are making do without care altogether.
Responding to McKee, some Rhode Island state officials voiced concerns that waiting another two years to raise provider rates could lead to further problems in the state’s health care landscape.
McKee is “hanging his hat on promises of future studies and reviews, demonstrating a deep misunderstanding of the issues at hand,” said Rhode Island Attorney General Peter F. Neronha in a statement Tuesday.
Arches Medical has taken on at least 2,000 of Anchor Medical’s patients, Gellis told the Globe, and is offering jobs to some of Anchor’s providers. But it’s a costly endeavor for practices, he said.
McKee also announced Tuesday that the state would provide $5 million in grants for primary care practices, to support the recruitment and retention of providers and increase “access and capacity” to serve patients. Interested practices can receive a maximum of $375,000 each. Applications are due May 16.
“If that gets into people’s hands quickly, that will be significant in the short,” said Gellis. When asked how quickly his practice would need to receive those funds to help bridge a gap, Gellis said, “Now.”
Neronha, who has been increasingly critical of McKee on health care issues, called the grant program “incremental” and “vaguely defined,” saying that it will pay administrative costs “rather than increasing reimbursement to primary care physicians.”
Anchor Medical has been in business for 25 years, employs 22 providers and had offices Lincoln, Providence, and Warwick. State officials said they did not know how many patients had successfully found a new provider, citing the Health Insurance Portability and Accountability Act, or HIPAA, a federal law designed to protect privacy of an individuals’ health insurance coverage.
Despite Anchor’s “positive reputation” and diverse payer mix between public and private payers, Secretary Richard Charest, who oversees the R.I. Executive Office of Health and Human Services, said Anchor’s closure was “primarily due to internal operational challenges.” When asked for more information by a Globe reporter, Charest said only, “they had no liquidity in the end.”
McKee also filed a budget amendment to require hospitals, nursing facilities, health care centers, behavioral health clinics, large physician practices and other providers to submit quarterly financial reports to the state. He said these reports will create an “early warning system” that will allow the state to solve issues with financially troubled health care organizations “before they reach the point of no return.”
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