§ 42-7.2-16. Medicaid System Reform 2008.
(a) The executive office of health and human services, in conjunction with the department
of human services, the department of children, youth and families, the department
of health, and the department of behavioral healthcare, developmental disabilities
and hospitals, is authorized to design options that further the reforms in Medicaid
initiated in 2008 to ensure that the program: utilizes competitive and value-based
purchasing to maximize the available service options, promotes accountability and
transparency, and encourages and rewards healthy outcomes, independence, and responsible
choices; promotes efficiencies and the coordination of services across all health
and human services agencies; and ensures the state will have a fiscally sound source
of publicly-financed health care for Rhode Islanders in need.
(b) Principles and goals. In developing and implementing this system of reform, the executive office of health
and human services and the four (4) health and human services departments shall pursue
the following principles and goals:
(1) Empower consumers to make reasoned and cost-effective choices about their health by
providing them with the information and array of service options they need and offering
rewards for healthy decisions;
(2) Encourage personal responsibility by assuring the information available to beneficiaries
is easy to understand and accurate, provide that a fiscal intermediary is provided
when necessary, and adequate access to needed services;
(3) When appropriate, promote community-based care solutions by transitioning beneficiaries
from institutional settings back into the community and by providing the needed assistance
and supports to beneficiaries requiring long-term care or residential services who
wish to remain, or are better served in the community;
(4) Enable consumers to receive individualized health care that is outcome-oriented, focused
on prevention, disease management, recovery, and maintaining independence;
(5) Promote competition between healthcare providers to ensure best value purchasing,
to leverage resources, and to create opportunities for improving service quality and
performance;
(6) Redesign purchasing and payment methods to assure fiscal accountability and encourage
and to reward service quality and cost-effectiveness by tying reimbursements to evidence-based
performance measures and standards, including those related to patient satisfaction;
and
(7) Continually improve technology to take advantage of recent innovations and advances
that help decision makers, consumers, and providers to make informed and cost-effective
decisions regarding health care.
(c) The executive office of health and human services shall annually submit a report to
the governor and the general assembly describing the status of the administration
and implementation of the Medicaid Section 1115 demonstration waiver.