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This program supports the implementation of Comprehensive Primary Care Plus (CPC+) in Rhode Island. It offers additional payer participation, data collection and reporting support, practice facilitation, and opportunities for quality improvement. Participating practices receive payments for value, infrastructure support, and incentives for quality and utilization. The program also provides pathways for practices not participating in or participating in an ACO, as well as opportunities for clinicians to meet Advanced Alternative Payment Model requirements. For more information, please contact the Care Transformation Collaborative of Rhode Island.
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Care Transformation Collaborative of Rhode Island Supporting the Implementation of Comprehensive Primary Care Plus (CPC+) Advancing Primary Care in Rhode Island August 2016
Benefits of Participation in CTC-RI • Additional payer participation (PMPM) in CTC-RI (e.g. Medicaid Managed Care) • Supports data collection, reporting and utilization for performance measurement • Provides hands-on practice facilitation – Practice facilitators provide on-site transformation coaching Partnering in Best Practice Quality Improvement opportunity • Assistance with NCQA PCMH recognition • Preparation for sustainability payments under OHIC • Monthly, quarterly, and annual learning collaborative meetings
CTC Payment and Delivery Model Payment for Value • Infrastructure payments for care management and becoming a patient centered medical home • Incentive payments for quality, customer experience and utilization • Alignment with the Office of Health Insurance, CPC+ and MACRA Incentives • Delivery System Improvements • Access and Continuity • Care Management • Care Coordination • Patient and Family Engagement • Data Driven Population Health Management • Practice as a patient centered medical home
CPC+ Implementation in RI • Pathway for practices notparticipating in an ACO • Accepted in CPC+ Track 1 • CPC+ payer partners provide additional support through CTC • Three year common contract (includes alignment with OHIC requirements for PCMH sustainability payments) • Practices align with an ACO value-based contact in year 4 and 5 • Pathway for practices participating in an ACO • Accepted in CPC+ Track 1 or 2 • Participate in commercial ACO shared savings contracts • ACOs direct support for practice level transformation An opportunity for clinicians meeting the statutory thresholds to be considered as meeting Advanced Alternative Payment Model requirements. For 2019-2024, qualifying clinicians would be excluded from Merit Based Incentive Payment System (MIPS) requirements and quality for a 5% APM incentive payment.
Additional information • CTC+: https://innovation.cms.gov/initiatives/Comprehensive-Primary-Care-Plus • For any additional questions, please contact Care Transformation Collaborative: Care Transformation Collaborative of RI ctcri@umassmed.edu ctc-ri.org 401-528-3271
CTC Practices Reduce In-Pt Admissions CTC Savings $21,231,824 Total Program costs (15-16) $15,754,793 Net Savings $5,477,031
