Patrick Tigue
Managing Director, Regional Managed Care Organizations
Health Management Associates
Boston, MA
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Patrick Tigue is an accomplished executive with experience leading and managing critical efforts to achieve strategic health policy goals on a statewide scale. He is a results-oriented and decisive leader with proven success in the government and payer arenas across the commercial health insurance market and the Medicaid market. Patrick has a track record of expanding access to care and improving affordability and quality in the healthcare system through delivery system and payment reform.
As health insurance commissioner, he led the State of Rhode Island Office of the Health Insurance Commissioner, regulating the fully-insured commercial health insurance market consisting of approximately 200,000 individuals across the individual, small group, and large group markets. Patrick was responsible for critical functions such as health insurance rate review, health insurance form review, network plan certification, consumer and provider complaint resolution, and market conduct examinations.
He authored and negotiated the Compact to Accelerate Advanced Value-Based Payment Model Adoption in Rhode Island, which was signed by consumer advocates, employers, government officials, payers, and providers and represented a consensus framework for transforming payment away from fee-for-service to a prospective budget-based model. Patrick advised on the statewide impact of the proposed consolidation of the state’s two largest hospital systems which involved overseeing the development and dissemination of working papers focused on policy considerations and payment model characteristics. He also expanded access to telehealth by supporting new statutory requirements such as parity for behavioral health and primary care reimbursement, cost-sharing, and prior authorizations.
In his prior role as assistant secretary for health and Medicaid director, Patrick led the State of Rhode Island Medicaid Program, serving approximately 300,000 residents and managing a $2.5 billion annual budget. He successfully managed the program within budget constraints while maintaining eligibility and benefits including expanding access to life-saving hepatitis C treatment. Patrick also negotiated an extension of the Rhode Island Comprehensive Demonstration 1115 waiver with the Centers for Medicare and Medicaid Services to preserve critical federal flexibility and funding including support for the state’s Medicaid accountable care organization program. During this time, he served as east regional representative for the board of directors of the National Association of Medicaid Directors.
Patrick earned his master’s degree in public policy from Brown University and a bachelor’s degree in English from the College of the Holy Cross. He also completed the Center for Health Care Strategies Medicaid Leadership Institute.