We both remember when Rhode Island’s major banks were headquartered here in Rhode Island. They kept management decision-making and high-paying jobs in the state while supporting local law firms, accountants, and other service providers. Bank executives provided a strong core of local civic leadership. When the banks merged out of state, it weakened the economic ecosystem. One of the best-known buildings in downtown Providence is a vacant former bank building.
The same thing could happen in health care. Our hospitals could become subsidiaries of out-of-state chains, and we’d again hear that same sucking sound of professional jobs and service contracts moving out of Rhode Island to the new out-of-state headquarters. Once more, we would lose the civic participation that local executive leadership provides. Fragmented, out-of-state health care leadership will make it harder for Rhode Island to accomplish critical health care reforms needed to assure healthy communities and high quality health care for Rhode Islanders.
In Washington, Congress and the White House continue to wrangle over the fate of the Affordable Care Act. Meanwhile, over the many years, Rhode Island has laid the building blocks for meaningful health-care reform. Rhode Island’s eight first-rate community health centers, beneficiaries of the ACA, provide access to high-quality medical, dental, and behavioral health care services to over 170,000 individuals throughout the state. The Rhode Island Chronic Care Sustainability Initiative was the first to align all health insurers, including the federal Medicare program, to support primary care practices.
Thanks to the ACA’s commitment to supporting primary care, we have primary care doctors and their teams improving care and lowering average patient cost through new payment and care delivery strategies like accountable care efforts. Rhode Island has consistently led the nation in efforts to expand the utilization of health information technology. Through the State Innovation Model and Medicaid reform waiver, we have federal buy-in to develop in Rhode Island a more caring, responsive, and low-cost system.
There wasn’t much policy difference among states when it came to banking, but in health care, there’s a big opportunity for Rhode Island if we can put all these pieces together into a best-in-class health care delivery system. Better health care, at lower cost, will boost all Rhode Island businesses and provide a more stable and healthier workforce.
So whether it’s jobs at issue, or community leadership, or command over our health care destiny, the stakes are high. We have seen a number of transactions that have resulted in Rhode Island hospitals being sold to out-of-state entities. The question we must face for any hospital merger proposal is what is a critical tipping point — a point of no return — for local control of our health care destiny. With our hospitals no longer under local control, will we still be able to chart a course that results in a healthier Rhode Island? Or will it become impossible to reconcile the out-of-state leadership of our hospitals with any common Rhode Island strategy? Will out-of-state CEOs even return a governor’s or a health director’s calls in a timely manner?
As our state looks at hospital mergers, we must ask these questions and demand that proposals address critical Rhode Island needs. We must make sure the answers are consistent with Rhode Island values, and ultimately are right for Rhode Island and our health-care consumers — particularly if we are at a point of no return.
Sheldon Whitehouse, a Democrat, is a U.S. senator from Rhode Island. Jane Hayward is president and CEO of the Rhode Island Health Center Association.
