CEO picked for health insurer for low-income

Mark Reynolds, who ran Medicaid programs in Massachusetts and Tennessee, succeeds Christopher F. Koller, who became Rhode Island's first health insurance commissioner.

01:00 AM EDT on Wednesday, August 31, 2005

BY FELICE J. FREYER
Journal Medical Writer

PROVIDENCE -- Neighborhood Health Plan of Rhode Island, the HMO that cares for 58 percent of RIte Care enrollees, has selected the former director of Medicaid programs in two other states as its new chief executive officer.

Mark Reynolds, 42, of Boston, replaces Christopher F. Koller, who resigned last spring to become Rhode Island's first health insurance commissioner. Reynolds, whose wide-ranging career included a recent stint as special assistant to Boston Mayor Thomas M. Menino, is scheduled to start on Oct. 3.

"We believe Mark is a man of integrity who has the same passion as Neighborhood for serving people who may be left behind," said Ernie Balasco, the chairman of Neighborhood's board and its acting CEO, at a news conference announcing the appointment. Neighborhood started a nationwide search for a new CEO in January.

Neighborhood was founded in 1993 by a group of community health centers to serve people enrolling in the state's RIte Care program, which started in 1994. RIte Care offers health insurance for people with low incomes, primarily young families. Under RIte Care, the state's Medicaid program contracts with three health insurers to provide a specified set of services for a flat fee per enrollee.

Reynolds has experience with two other similar Medicaid programs. From 1996 to 1999, he was deputy commissioner of the Massachusetts Medicaid agency, where he helped establish a managed-care program serving 940,000 people. In 1999, he became acting commissioner in Massachusetts, and in 2000 he moved to Tennessee to become director of the troubled TennCare program.

Founded in the same year as RIte Care, TennCare is as famous for its failures as RIte Care is for its successes. RIte Care, after some initial growing pains, came to be regarded as a model program that improved access to care and the quality of care for children and pregnant women. But TennCare has long been mired in difficulties, including backlogs, deficits and lawsuits, and this year TennCare dropped 320,000 people. Reynolds was TennCare's eighth director, and he resigned after two years.

In an interview yesterday, Reynolds said he quit TennCare in part because he disagreed with the state's decision to cut off a population of people who could not get insurance in the private market. A key problem with TennCare, he said, lay in its origins: It was rolled out quickly without forging partnerships with providers and advocates. RIte Care, in contrast, built a strong coalition at the outset.

In 2003, Reynolds was hired as special assistant to Boston's Mayor Menino, a job he held until September 2004. Since then he has worked as a consultant to health plans, providers and advocates.

As CE0 of Neighborhood, Reynolds will oversee a $174-million HMO with 175 employees and 75,000 enrollees. He said he plans to work on improving care by setting standards and providing incentives to meet them. He's also looking to expand Neighborhood's reach to other groups, such as disabled people, who need guidance navigating the health-care system.

Reynolds' parents and sisters live in Rhode Island, but he said he would probably continue to live in Boston, because his wife, Clare Reilly, directs a homeless shelter there, and they have a newborn son.