1. Care Transformation Collaborative of Rhode Island Supporting the Implementation of Comprehensive Primary Care Plus (CPC+) Advancing Primary Care in Rhode Island
August 2016

2. 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

3. 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

4. CPC+ Implementation in RI
Pathway for practices not participating 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 , qualifying clinicians would be excluded from Merit Based Incentive Payment System (MIPS) requirements and quality for a 5% APM incentive payment.

5. Participation in CPC+/CTC-RI
Per member
per month
infrastructure
payments
Readiness for upcoming federal and state primary care alternative payment models. A
"voice at the table"
with primary care providers and health plans working together to improve care at lower costs
For
clinicians, meeting statutory thresholds would be excluded from Merit Based Incentive Payment System (MIPS) requirement and quality for 5%
APM incentive
payment.
CPC+ qualifies as an Advanced Alternative Payment Model

6. Additional information
CTC+: Care-Plus
For any additional questions, please contact Care Transformation Collaborative:
Care Transformation Collaborative of RI
ctc-ri.org

7. Questions?

8. Additional Slides for Reference Only

9. CTC Practices Reduce In-Pt Admissions
CTC practices also demonstrated inpatient savings for Fiscal Year Practices have shown less inpatient hospitalizations than the comparison group, translating to significant cost savings shown below.
Since 2012, we have tracked the number of
inpatient hospitalizations attributed to our
practices, organized in three cohorts. Compared
to non-CTC practices, all three cohorts March 2012-June 2015 have greater reduction rates of patient hospital admissions (from all causes)
than the comparison group.
CTC Savings $21,231,824
Total Program costs (15-16) $15,754,793
Net Savings $5,477,031

10. Quality Data

11. CAHPS Data CTC Survey Results Compared with National Comparison
CTC Practices are generally on par with national benchmarks, but do better in adult behavioral care coordination and less well on office staff.