A look at the “experience of Rhode Island’s statewide payment innovation model and the Center for Medicare and Medicaid Innovation (CMMI)” and how each has played a role in the state’s healthcare transformation, specifically as it relates to primary care. The article emphasizes the need to invest more in primary care to “sustain transformation” and ensure better patient outcomes. Examples of critical investments to improve the primary care experience include: “improved access and continuity; planned care for chronic conditions, preventive care for high-risk patients, and team-based integration of behavioral health; risk-stratified care management; patient and caregiver engagement, and; coordination of care across the medical neighborhood.”
Rhode Island’s Care Transformation Center (CTC) monitors the payments/investments in primary care as well as the quality of care. “Through the guidance of the CTC, Rhode Island experienced a substantial increase in the number of patient-centered medical homes in the state, and95 percent of practice sites have achieved medical home status...primary care practices have begun to include other features common to patient-centered medical homes that have been shown to improve patient outcomes, such as behavioral health integration and community health teams. Based on success over the past five years, payers have even increased the fee schedule for patient-centered medical home practices, convinced that these advanced primary care models will improve outcomes for patients and concurrently hold down costs.”
While early results show positive gains towards both return on investment and improved patient experience in Rhode Island, Health Affairs notes that this progress has happened over five years and is the result of much time, effort, and commitment. In addition, this is one example of how to approach healthcare transformation and there is much more work and “experiments” to be done to determine how to “create a payment system that enables primary care to serve as the efficient and valued foundation of a high-functioning health system.”
Similarly, Delaware is prioritizing healthcare transformation in the state with DCHI’s Clinical Committee. By advancing initiatives to help clinicians achieve greater efficiencies, lower cost, and improved care for patients, the Clinical Committee supports all aspects of health care transformation to better align health care delivery models, the provider experience, and community health outcomes. For more information, please visit us at https://www.dehealthinnovation.org/.
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