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“Alignment” for Transformation

“Alignment” for Transformation. NGA: Learning from Each Other January 14, 2014. Rhode Island Structure for Alignment. Executive Committee of Health Care Reform Commission. Lieutenant Governor (Chair). Secretary of Health and Human Services. Health Insurance Commissioner.

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“Alignment” for Transformation

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  1. “Alignment” for Transformation NGA: Learning from Each Other January 14, 2014

  2. Rhode Island Structure for Alignment Executive Committee of Health Care Reform Commission Lieutenant Governor (Chair) Secretary of Health and Human Services Health Insurance Commissioner Director of Administration Governor’s Policy Director Medicaid Public Health Behavioral Health Facilities Regulation State Employees Health Benefits Exchange Commercial Insurance Regulation

  3. Examples of Alignment in Rhode Island QHP Standards and Certification Eligibility IT System Patient-Centered Medical Homes • Exchange Develops Standards • Health Insurance Commissioner certifies Insurers • Jointly developed, overseen and paid for by Medicaid, Exchange and Department of Administration • Health Insurance Commissioner initiated provider collaborative; “strongly encouraged” insurer participation • Medicaid engaged in payments after 2 years • State employees plan to begin payments after legislation

  4. Lessons learned in alignment Bureaucracy has outlived previous administrations and will outlive this one Tone from the top and commitment of cabinet officials will define opportunity for success Governor leadership critical How official talk, formally and informally Competing priorities must be resolved ASAP Alignment is not just policy-based Lt. Governor is RI has no administrative authority or oversight Served as facilitator for alignment (social workers) Neutral party very valuable Lobbyists and interest groups will test the limits and exploit any weaknesses in the fronts “Invisible Fence” Theory

  5. Interacting with the market • Widespread appreciation of the talent and commitment of State staff – but recognition that the system places great constraints on them • Several stakeholders in private market lamented State’s inability to “speak with a singular voice” – frustration that the agendas of different agencies/branches are often in conflict with each other • Frustration due to perception that State continually subjects providers to change; some of which is unnecessary and burdensome • Concern that State leadership does not adequately understand healthcare marketplace Trustworthiness of Government Questioned Interviews with 36 external stakeholders

  6. Strategies for Multi-Payer Alignment Give CEOs a single person to discuss strategy and policy Provides a place for venting and problem solving Single point of contact Creative development of things that keep people happy Aligned quality measures, rather than just a requirement to move to an outcome-based system Give marketplace carrots first When alignment causes strife, call it out and work it out There will be times when agencies don’t line up. Don’t force it, fix it. Admit to internal speedbumps Legislative initiatives can be detrimental to marketplace – executive branch can play a critical role in understanding the viewpoints of the market Fight for some of their interests

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