RIte Care Program Monitoring
To assess whether the RIte Care program has been successful in meeting its goals and
meeting the health care needs for which it was designed, data will be collected to
assess changes in the following target areas:
- Access to care based on:
- Focus group data.
- Clinical studies.
- Annual health plan comprehensive site visits.
- Member satisfaction surveys and complaints and grievances.
- Provider participation data.
- Service utilization data (e.g., physician visits, emergency room visits, and hospital
utilization).
- Impact on maternal health utilizing data on:
- Number of women with short intervals between births.
- Number of pregnant women entering prenatal care in the first trimester.
- Adequacy of prenatal care.
- Percentage of pregnant women who smoked during pregnancy.
- Impact on infant health by comparing inner-city Providence infant
health statistics pre- and post-RIte Care.
- Member satisfaction utilizing member surveys. In 1996, 1,009 members
were surveyed, and in 1997, 1,344 members were surveyed.
- Health plan performance utilizing data related to:
- Provider network composition.
- Covered services and standards.
- Member services.
- Provider services and accessibility.
- Marketing.
- Grievance and appeals procedures.
- Encounter data reporting.
- Financial performance.
- Quality assurance standards.
Lessons learned from the early implementation of the program have been
that:
- Broader coverage does not necessarily mean greater costs.
- Partnerships between the State and the Health Plans are critical to success.
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