Rhode Island

Rhode Island has a long history and continued commitment to using the PCMH as the foundation for all health care improvement efforts in the State. In 1999, the Rhode Island Chronic Care Collaborative grew out of a partnering of the Rhode Island Department of Health Diabetes Prevention & Control Program and the Thundermist Health Center in the Bureau of Primary Health Care Health Disparities Collaborative for diabetes. Between 2000 and 2002 the Diabetes Prevention and Control Program created an in state collaborative with the addition of ten community health centers and one hospital-based practice. In 2003 the Diabetes Prevention and Control Program and Quality Partners of Rhode Island (now Healthcentric Advisors) received a grant from the Robert Wood Johnson Foundation’s Improving Chronic Illness Care program to train physician practice teams based on the Bureau’s Collaborative model. 

Launched in 2008 by the Office of the Health Insurance Commissioner, the R.I. Chronic Care Sustainability Initiative (CSI-RI) brings together key health care stakeholders to promote care for patients with chronic illnesses through the patient-centered medical home (PCMH) model. CSI-RI began with five pilot sites in 2008, added eight sites in 2010 and another three sites in October 2012. Currently, over 85,000 Rhode Islanders receive their care from CSI-RI practices. Over the next five years, 20 practices will be added each year, with the goal of providing over 500,000 Rhode Islanders with access to a PCMH. 

In July of 2011, Rhode Island passed 2011 S 770 – Rhode Island All-Payer Patient Centered Medical Home Act of 2011, which directed the Health Insurance Commissioner to create a Patient-Centered Medical Home Collaborative. The Collaborative conisted of various stakeholders including providers, insurers, patients, hospitals, and state agencies, and was required to develop a payment system that mandated all insurers to provide care coordination payments to PCMHs by July of 2012. The Act requires that the care coordination system be in place through at least July of 2016.  

Rhode Island’s State Health Care Innovation Plan builds on the success of all these programs and include ongoing training and payment support for primary care practices transforming to PCMHs, integration of behavioral health in primary care, increased use of ACO's or ACO-like structures to align payment with quality, expanding the use of community health teams for high-risk populations, and continued development of analytic tools that can be leveraged by the State, providers, and payers.

For more detailed information about public programs in Rhode Island, visit the National Academy of State Health Policy.

CHIPRA: 
No
MAPCP: 
Yes
Dual Eligible: 
Yes
2703 Health Home: 
Yes
CPCi: 
No
SIM Awards: 
Yes
PCMH in QHP: 
No
Legislative PCMH Initiative: 
Yes
Private Payer Program: 
Yes
State Facts: 
Population:
1,048,300
Uninsured Population:
9%
Total Medicaid Spending FY 2013: 
$1.9 Billion 
Overweight/Obese Adults:
64.6%
Poor Mental Health among Adults: 
35.3%
Medicaid Expansion: 
Yes 
CPC+: 
CPC+

Blue Cross CEO: Collaboration at core of integrated care

Payers and providers must lay the foundation of collaboration to create an integrated healthcare system that coordinates care, lowers costs and boosts quality, according to the chief executive of Blue Cross Blue Shield of Rhode Island.

"To take waste out of the system and eliminate unnecessary spending, all caregivers and the insurers have to be aligned and committed to making hard changes," BCBSRI CEO Peter Andruskiewicz said in an interview withProvidence Business News. "These changes will be good for quality of care and for costs."

News Author: 
Dina Overland

20 More Primary Care Practices To Join CSI-RI

A statewide effort to link more Rhode Islanders with primary care is expanding. The effort is called the Chronic Care Sustainability Initiative, or CSI. CSI promotes the patient-centered medical home model of health care. In a patient centered medical home, a team of health care professionals coordinates a patient’s care. It’s especially helpful for patients with chronic illnesses, although anyone can join.

News Author: 
Kristin Gourlay

New Report Finds Medical Homes Are Reducing Health Care Costs, Utilization, and Improving Health

A review of the year’s academic and industry-generated PCMH evaluations finds significant impact across a number of clinical and financial outcomes.

Embargoed Until Monday, January 13th, 4PM

PCPCC: Michelle Shaljian, 347-754-1692, michelle@pcpcc.net

Milbank: Tara Strome, 212-355-8400, tstrome@milbank.org

New Report Finds Medical Homes Are Reducing Health Care Costs, Utilization, and Improving Health

Clinical Psychology Training Consortium

The Providence VA Medical Center offers training programs in Patient-Aligned Care Teams in the field of primary care in behavioral medicine/health psychology.

Rhode Island Health Homes

Rhode Island has 3 approved 2703 Health Home State Plan Amendments.

Care Transformation Collaborative of Rhode Island (CTC)

Launched in 2008 by the Office of the Health Insurance Commissioner, the  Care Transformation Collaborative of Rhode Island (CTC) (formerly the R.I. Chronic Care Sustainability Initiative (CSI-RI)) brings together key health care stakeholders to promote care for patients with chronic illnesses through the patient-centered medical home (PCMH) model. CTC-RI began with five pilot sites in 2008, added eight sites in 2010 and another three sites in October 2012.

BCBS RI Patient Centered Medical Homes

Blue Cross & Blue Shield of Rhode Island (BCBSRI) is working with primary care practices in Rhode Island to help improve patient/member "experience of care" while empowering them to be actively involved in their care plan; improve quality of healthcare in a population of patients; support the primary care infrastructure in Rhode Island; maximize skills of all members of the care team to provide the most efficient care to patients; and create lower overall costs (i.e., "waste" management) through improved coordination of care with electronic health records

CMS State Innovation Model (SIM) Test Award - Rhode Island

Rhode Island intends to build upon its successful foundation of patient-centered medical homes to transform its health care system into a health care system organized around patients, with improved community health as its goal, which is firmly rooted in a strong and diverse primary care system. The model will leverage the opportunities provided by the state's Health Benefits Exchange and Medicaid initiatives.

CMS Health Care Innovation Award - Living Rite-A Disruptive Solution for Management of Chronic Care Disease

The University of Rhode Island’s Living Rite Innovations project received a $14 million grant to improve the health of cognitively challenged adults with chronic diseases and those with Alzheimer's who receive Medicare and Medicaid benefits while reducing the costs of care. The program will integrate the efforts of state agencies, major health systems, educational institutions, disability organizations and service providers to lower costs and provide comprehensive health care for dual-eligible Medicare and Medicaid beneficiaries who are over the age of 20.

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