Credit for Healthcare Initiatives

When you read the following, from today’s Providence Journal, who do you think ought to get credit for the innovation?

So with Governor Raimondo pushing her cost-cutting Reinventing Medicaid initiative, Neighborhood Health Plan of Rhode Island is eagerly touting what it says is the early success of a program begun just five months ago to address Medicaid subscribers with frequent and hefty medical bills.

Astute readers might pick up on the fact that the program began five months ago, which would mean the governor would have been implausibly dynamic to get it rolling, if it was possible at all.  Still, you should be forgiven if you finished the paragraph with the impression that Reinventing Medicaid is to credit.  How about this one?

Most states have not [advanced data and analytics to target high-cost insurance members], because of the intense partisanship over “Obamacare” and in some cases because of technical problems.

Instead, they rely on the federal HealthCare.gov website. Rhode Island, however, has its own health-care exchange, HealthSource RI.

So, maybe it’s HealthSource to credit, then.  But wait a moment:

The program has been in development for two years and is similar to other projects under way in the state, Trilla said. Given Reinventing Medicaid’s goals of targeting so-called “high utilizers,” he said that Health@Home has “ended up dovetailing nicely” with the governor’s efforts.

Two years ago would be May 2013, at which point HealthSource was still in development (based on wildly inflated projections).  That suggests this innovation was not driven by Governor Raimondo, and it was not driven by ObamaCare or HealthSource RI.  Rather, one can infer that it was driven by a private organization’s assessment of how it might better use its resources.

Maybe we can find our way to giving government some credit if Neighborhood’s innovation was inspired by the much-maligned Global Waiver program (to which Raimondo’s Reinventing Medicaid initiative bears some striking resemblance), but then the credit would have to go to Republican President Bush and Republican Governor Carcieri.  ObamaCare and Democrats actually hindered savings from that effort.

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