Langevin (left) with Sisun

CRANSTON — The Rhode Island Rehabilitation Center’s facility looks nothing like a hospital.

Its building on Route 2 was a Toyota dealership before the physical-therapy center took it over in 1993. Next door are a CVS, a Walgreens and a Cumberland Farms. Nobody’s going to rechristen the area a “Knowledge District.”

But the Rehabilitation Center employs about 60 people at seven locations in Rhode Island, and that’s one reason Congressman Jim Langevin visited there Thursday “to see how we can help businesses in the health care field.” CEO Henry Sisun founded the for-profit Rehabilitation Center in 1988, and it’s a minnow in the Rhode Island medical industry compared with huge providers like Rhode Island Hospital parent Lifespan, the state’s largest private employer, which had $1.5 billion in revenue in 2009.

Langevin described Thursday’s visits as a “listening tour” – and Sisun gave him plenty to listen to. “Right now we’re fighting so many things,” he said: inadequate reimbursement rates, required health IT purchases (“which is not going well for us”), higher copays for patients and employees, a new cap on visits that Blue Cross is implementing in December, a drop in revenue due to the recession, endless paperwork and bureaucratic hangups.

The amount the center gets paid to provide the same service as a hospital is a particular sore spot. ”This has been a bone of contention of private enterprise,” Sisun said. “It’s out there. The insurance commissioner knows about it. They get reimbursed three to four times [what we do]. They have sweetheart deals with the insurance companies so that they can dictate what they get reimbursed, because they have their costs.”

Sisun argues that dynamic drives the cost of health care higher, because big organizations can use their market heft to charge more without providing better service than a leaner outfit like his. He also says smaller enterprises are more likely to drive innovation that will bring down costs, which will also help restrain government budget deficits.

Langevin told Sisun he’s hopeful the pilot programs and other measures included in last year’s health reform law will do more to encourage efficiency in the industry, particularly once the state insurance marketplaces known as exchanges get up and running in 2014.

“We’ve got a lot of work to do in terms of how we provide value for the level of care, but also proper reimbursement for the people providing care,” the congressman said. “We have the challenge of providing better care, better outcomes, at lower costs.”

Though much of the discussion at the Rehabilitation Center centered around health-specific issues, Langevin’s stated purpose for visiting was to talk about jobs. The number of jobs in Rhode Island’s health care and social assistance sector has actually grown by 4,000 since December 2006 – a period when total employment dropped by 29,700. And economists expect the sector to keep adding jobs in the coming years, particularly as the population gets older.

A key concern for Langevin is the skills gap. He says Rhode Island employers tell him they have jobs open but can’t find anybody qualified to fill them, despite being in a state with roughly 60,000 jobless residents. And Sisuan, who got his undergraduate degree at URI’s nursing school, said his workers don’t get training in specialized areas like physical therapy for cancer patients, which forces his company to cover the full cost of getting them up to speed.

(photo: Ted Nesi/WPRI)