It’s hard for me to believe, but I just reached the one-year mark of being at BCBSRI in late June. As I reflect on the past year, I’m extremely proud of what we’ve been able to accomplish – while acknowledging there’s so much more still to do – but also very hopeful for the future. When I came on board last summer, we were in the middle of so much work aimed at satisfying our three-year strategy.

With this month’s update, I thought I’d share some thoughts around some of that work to date. One of the key pieces of our strategy is advancing value-based care models with our participating providers. VBC will keep patients healthier, improve health outcomes, and lower costs while providing improved provider compensation for reaching certain goals. While BCBSRI has worked with our providers to develop and expand VBC programs to lower costs and achieve better health outcomes for Rhode Islanders for nearly 15 years, today—using a data-driven approach—we continue to invest in this model to support the local healthcare system, most notably PCPs, specialists, and hospitals, to bridge the economic challenges facing the healthcare industry, and create new revenue sources for providers and practices.

We’ve been extremely focused on the importance of reducing administrative burden for our participating providers and managing medical costs. One way we’re addressing that burden is our recent commitment to eliminate nearly 65% of prior authorization requirements for PCPs by early 2025. Look for more details as that date gets closer, and read more about it here.

We’ve also made maternal health equity a top priority with lots of recent work in this space. First, we increased the annual reimbursement for services from in-network doulas – including labor, delivery, and prenatal/postnatal visits – from $1,500 to $2,400. This change was made to coverage for members in all fully insured plans, whether purchased directly from BCBSRI or through HealthSource RI. And we announced a new partnership with Doulas of Rhode Island to expand a scholarship program that focuses on supporting and improving diversity in the state’s doula community. And speaking of doulas, we’re offering virtual access to them as just one part of a brand new offering for select customers called Maven. Maven offers free virtual support for family building, pregnancy, parenting, and menopause. This member-focused experience will promote improved health outcomes.

I’m also incredibly proud of the progress we’ve made in terms of youth behavioral health, another component of our strategy. Specifically, we’ve committed to supporting the mental well-being of 50 percent of RI youth under age 18 (roughly 110,000 youth) by 2025 by engaging them, caretakers, schools, the community, and our healthcare network. We’ve undertaken, supported, and funded so much work to make that happen, including emotional wellness activities in places where we can reach youth, providing digital emotional wellness coaching to families and caregivers, training providers in evidence-based care, expansion of outpatient capacity, embedding community health workers in PCP’s offices, training youth organizations in youth mental health first aid, mobile crisis intervention, expanded funding for urgent access BH appointments, and successful transitions for families. This is not even an exhaustive list – read more about our efforts in this area here.

Thank you!

We want you to know that we’re here for you – and we welcome any questions or thoughts you have. And as always, thank you for all you do to keep our members and all Rhode Islanders safe and healthy.