Onward & Upward

Just before going to press, however, Koller-who had served as the company's CEO since 1996-was nominated by Gov. Donald Carcieri to be Rhode Island's first-ever Health Insurance Commissioner, a role that will make him the point person for all healthcare access and affordability initiatives in the state.

"As CEO of Neighborhood Health Plan of Rhode Island, Chris is a nationally recognized leader in the healthcare field," Carcieri says. "He has long been acknowledged as Rhode Island's most innovative advocate for high-quality, affordable healthcare. His long background in healthcare management, as well as his stewardship of Neighborhood Health Plan, make him the perfect candidate for the job."

What went before Having coordinated care for the Medicaid population for the last decade provided experience that will serve Koller well in his new role.

"The statutory mandate of the Health Insurance Commissioner is 'to look at the healthcare system as a whole.' Insurance payment and benefit policies have profound effects on the behavior of consumers and providers," he says. "At NHPRI, we used them to increase behavioral health provider capacity and pay for quality. We also focused on improving access to care: the insurance card, plus an educated consumer and a collaborative provider. My challenge as Health Insurance Commissioner will be to help our health system evolve thoughtfully and have insurance practices that foster evolution."

Among his many accomplishments at NHPRI was presiding over the health plan in a state that is a national leader in Medicaid managed care and has the lowest rate of uninsured children in the country.

In 1996, NHPRI was a 27,000 member health plan with $30 million in revenue, about 40 people on staff, and a net worth of about $200,000. "I signed all the provider checks myself every week, knew the daily inpatient census, and spent a good deal of my days convincing major hospitals and regulators that we could make the trains run on time," Koller says. Eight and half years later-with 180 employees, $175 million in annual revenues and a net worth of $13 million-the plan is hardly a gorilla, but "that is the point-we collaborate with providers and members in way that is often innovative," Koller says. "Local providers who shunned us as the 'poor folks plan' now hold us up as the model. The same is true for well-run Medicaid managed care plans around the country. Providers respect our focus on collaborating with them to improve access."