Rhode Island Town Considering Community-Based Preventive Health Plan

The town of Scituate, R.I., is considering providing health care for town employees and residents through a community-based preventive health plan that could become a model for other small towns across the country, the Providence Journal reports. Under the plan, members would pay an annual premium -- likely $200 -- to join a local primary care center, which would provide preventive care at no additional cost. The Scituate Health Plan Committee would contract with an existing medical practice to run the center, which would include primary care physicians, visiting nurses, midwives, physical therapists and mental health professionals. The center would provide 85% to 90% of the average member's health services. Remaining care would be paid for through a medical savings account and a high-deductible insurance policy. Members and their employers would be required to contribute regular payments to an MSA -- possibly up to $2,500 per year -- and beneficiaries also would have to purchase a high-deductible health plan from a private insurer, which would kick in after the MSA had depleted. Dr. Michael Fine, who is leading the town's effort to create the health plan, said the system would reduce health costs by focusing on preventive care. "If you're working with a community, you have many different ways of helping people get what they need. You can run exercise programs in schools. You can work in nursing homes and old age homes. You can run cholesterol screenings when you have a Fourth of July celebration," Fine said. The plan, which the Journal says is just a "twinkle in the eyes" of the town committee, will require "big-time foundation money" to proceed (Freyer, Providence Journal, 8/19).