Investor Presentaiton
As previously reported by OHIC, Rhode Island's per capita growth in THCE exceeded
the state's target of 3.2 percent in 20193 COVID-19 significantly altered health care
utilization and spending in 2020. In particular, COVID-19 restrictions caused an abrupt
reduction in the use of in-person health care, which led to a sharp drop in per capita
spending in 2020.4 Utilization rebounded in 2021, although not to pre-pandemic
levels, resulting in a 3.2 percent growth in THCE, which was equal to the target (see
Exhibit 2.1). State-level performance in 2021 was heavily influenced by a decline in
Medicaid per capita spending, which may have been an artifact of federal action
during the Public Health Emergency.5
Trends in Statewide Spending by THCE Component
Aggregate spending in the commercial market was $2.3 billion in 2021, comprising
27 percent of state THCE (see Exhibit 2.2). Combined with a commercial market
enrollment decrease of 3.4 percent, this yielded a per capita spending level of $6,171,
which represents a 9.7 percent increase over 2020 (see Exhibit 2.3). This increase,
while far above the cost growth target, is below that of neighboring states with cost
growth targets for 2021.6
Exhibit 2.2: Aggregate Statewide Spending Growth by THCE Component, 2020-2021
$8,950
2021 per capita THCE
Medicare, $2.88B
9.1%
Medicare, $2.64B
Medicaid, $2.53B
7.6%
Medicaid, $2.72B
Commercial, $2.20B
6.1%
Commercial, $2.34B
NCPHI, $0.74B
2020
-10.0%
NCPHI, $0.66B
2021
Source: OHIC analysis of TME data from insurers, CMS, the Rhode Island EOHHS, and publicly available insurer regulatory filings.
$3.2%
Per capita trend
2020-21
3 OHIC, Performance Year 2020 Cost Trends Report, April 27, 2022, https://ohic.ri.gov/policy-reform/health-spending-accountability-and-transparency-program.
4 Federal relief payments, including to Rhode Island providers, caused national health care spending to increase in 2020. Those relief payments are not available for capture in OHIC's analysis,
however.
5 2021 per capita statewide spending was depressed as a result of negative Medicaid per capita trend (see Exhibit 2.3). This may be partially attributed to enrollees with extended Medicaid
coverage due to the suspension of Medicaid eligibility redeterminations, some of whom obtained and utilized commercial insurance but remained enrolled in Medicaid. OHIC is unable to
quantify the number of individuals affected.
6 In 2021, Massachusetts' per capita TME for the commercial market increased by 11.6 percent. For more information, see: Massachusetts Health Policy Commission, Hearing to Determine the
2024 Health Care Cost Growth Benchmark (slide 6), March 15, 2023.
https://www.mass.gov/doc/national-context-and-affordability-implications-of-massachusetts-trends-dr-david-auerbach/download. Connecticut's per capita TME for the commercial market
increased by 18.8 percent in 2021. For more information, see: Connecticut State Office of Health Strategy, Healthcare Cost Growth Benchmark Steering Committee Meeting, March 27, 2023.
https://portal.ct.gov/-/media/OHS/HBI-Steering-Committee/March-27-2023/Steering-Committee-meeting-3-27-23-Final-slides.pdf.
Delaware reported for 2021 a per capita increase in THCE of 16.5% in the commercial market (note that at the market level Delaware only reports THCE and not TME). For more information,
see: Delaware Department of Health and Social Services, Calendar Year 2021 Results: Benchmark Trend Report (slide 23), April 6, 2023.
https://dhss.delaware.gov/dhcc/files/de_cy_2021_benchmarkreport.pdf. Oregon's per capita TME for the commercial market increased 12.1% from 2020 to 2021. For more information, see:
Oregon Health Authority, Health Care Cost Growth Trends in Oregon, 2020-2021: 2023 Sustainable Health Care Cost Growth Target Annual Report (slide 17), May 9, 2023.
https://www.oregon.gov/oha/HPA/HP/Cost%20Growth%20Target%20documents/2023-Oregon-Cost-Growth-Target-Annual-Report.pdf.
Annual Report: Health Care Spending and Quality in Rhode Island
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