Strengthening Rhode Island’s Healthcare System

• In partnership with the Executive Office of Health and Human Services (EOHHS) and RIDOH, secured more than $156 million in first-year funding for the federal Rural Health Transformation Program through a comprehensive, community-informed application to modernize care delivery across Rhode Island communities.
  • Prioritized proposals to strengthen healthcare access, including:
    1. Expanding Access to Care Through Federally Qualified Health Centers (FQHCs): Improving access to primary care, behavioral health, and dental services for rural residents by positioning FQHCs as clinical anchors in their communities. 
    2. Delivering Hospital Care at Home: Expanding Hospital at Home programs to allow patients across the state to safely receive hospital-level care in their own homes—improving outcomes, lowering costs, and keeping families together during recovery. 
    3. Advancing Value-Based Care: Investing in value-based payment models that reward quality and outcomes rather than volume, helping primary care practices, community health centers, hospitals, and local providers deliver more coordinated, preventive, and cost-effective care. 
    4. Combating the Opioid Crisis and Expanding Behavioral Health: Strengthening behavioral health capacity by launching crisis stabilization facilities and recovery centers so residents in small and remote communities hit hard by the opioid epidemic can receive 24/7 community-based support closer to home. 
    5. Modernizing Health IT: Providing Health IT modernization grants to equip providers with the digital tools needed to expand telehealth, improve data connectivity, leverage AI for care coordination, and participate in value-based care—supporting better care delivery across Rhode Island’s 18 rural towns. 
    6. Growing the Health Workforce: Developing the workforce, including new clinical training placements, mentorships, and education-to-employment pathways in high-demand health care fields to better serve rural patients. 
    7. Investing in Mobile Health and Emergency Medical Services: Expanding mobile health services, a statewide tele-dentistry triage system, and major EMS modernization investments to expand access to coordinated, affordable care in rural communities. 
    8. Supporting Local Health Systems: Making investments to meet the distinct health needs of Block Island and the Narragansett Indian Tribe, strengthening local care systems and ensuring services reflect each community’s priorities and culture. 
    9. Building Integrated Community Care: Promoting integrated, community-based care models to improve chronic disease management, preventive care, and behavioral health services through local providers, community learning centers, and other trusted rural community institutions. 
• Secured federal approval from the Centers for Medicare & Medicaid Services to extend Rhode Island’s Section 1115 Medicaid Demonstration Waiver from 2026 through 2030, advancing a value-based, coordinated, and efficient Medicaid delivery system by:
  • Continued federal financial participation for core authorities, including managed care, home and community-based services, extended family planning, the Marketplace Subsidy Program, Peer Recovery Specialists, and Home Stabilization Services;
  • Expanded access to high-quality care by extending the Substance Use Disorder demonstration to support clinically appropriate treatment in residential and inpatient settings and by providing separate authority for the Family and Youth Support Partner Program; and
  • Broadened oral health coverage by providing Rhode Island the federal authority to expand the RIte Smiles dental managed care program to serve all Medicaid beneficiaries, not just children.

• Selected by the Centers for Medicare & Medicaid Services (CMS) to participate in the AHEAD Model (Achieving Healthcare Efficiency through Accountable Design), advancing a total cost-of-care approach to improve access and reduce health care costs, with up to $12 million in federal funding to support implementation over the next five to six years.
• Published a Federal Compliance Advisory Group report – established by EOHHS in consultation with the Governor’s Office to monitor and analyze federal actions – identifying key considerations related to policy changes affecting Medicaid, SNAP, and the Health Insurance Marketplace, following a review of more than 450 federal actions to assess impacts across EOHHS agencies and safeguard Rhode Island’s health and human services systems.
• Announced numerous strategic actions to strengthen Rhode Island’s primary care system in 2025:
  • In response to the closure of Anchor Medical, announced grants for primary care practices (PCPs) to support the recruitment and retention of PCPs and increase access and capacity to serve Rhode Islanders in primary care settings in April 2025. As of June 2025, awarded $6.7 million, inclusive of federal matching funds, to 85 primary care practices in Rhode Island, with some practices receiving over $200,000 for recruiting new doctors and accepting new patients.
  • For the first time since FY 2008, invested general revenue to provide additional investments in the Health Professional Loan Repayment Program for primary care providers and pediatricians in the FY 2026 budget.  As part of the program, those professionals commit to practicing in federally designated health professional shortage areas within Rhode Island for at least two years.
  • Accelerated the review of PCP rates by mandating that OHIC complete the primary care rate review one year earlier.
  • Implemented a new OHIC regulation requiring commercial health insurers to increase funding for primary care reimbursements over a four-year period, with the goal of doubling per-member primary care spending by 2029.
  • Signed legislation in 2025 eliminating all prior authorization requirements for in-network primary care providers for three years, reducing administrative burdens and allowing providers to deliver care more efficiently.

• Worked with Care New England and union leadership to help reach a resolution to the Butler Hospital strike.
• Finalized plans, in partnership with Neighborhood Health Plan of Rhode Island, to launch a new health plan for Rhode Islanders enrolled in both Medicare and Medicaid. The Fully Integrated Dual Eligible Special Needs Plan, set to begin on January 1, 2026, will provide support for members’ medical and non-medical services—including long-term services and supports and behavioral health care.
• Changed Disproportionate Share Hospital (DSH) payments to hospitals to new State Directed Payments, which provide additional funding to hospitals by paying a percentage of average commercial rates to reduce the gap between Medicaid hospital rates and commercial rates. This mechanism optimizes federal funding and strengthens our state’s health system in ways that better support affordable and accessible services to maximize health outcomes for all Rhode Islanders.