CSI-RI 2014 Expansion Update

CSI-RI is excited to announce that 25 primary care practice sites have been accepted to join the primary care reform initiative. This year's expansion grows CSI-RI to now include 43 primary care practices with 73 total practice sites, providing more than 320,000 Rhode Islanders with access to a patient centered medical home. 

The 25 practices were selected based on their track record as agents of change and their commitment to continuous, data driven improvements in health, healthcare and value.  

Check out this Providence Business News to learn more about the expansion and to view a list of the 25 new practice sites. 

Report: 2014 CSI-RI Focus Group Analysis

On September 30, 2014 CSI-RI hosted a focus group with 16 participants from CSI-RI affiliated primary care practices from across the state. The purpose of this focus group was to reach beyond the data received from the CAHPS survey each year and hear directly from patients about their anecdotal primary care experiences regarding levels of access to care, communication between patients and their primary care offices, how patient's health care decisions are made, and how care is managed by both patients and their primary care doctors. 

Among many takeaways, patients emphasized their desire to feel respected as a person and not just a number. It was clear that each patient had different expectations from their primary care doctors and practices as well as strong opinions about their personal care and how they wanted that managed. 

Congratulations from CSI-RI! 

Congratulations are extended to Mary Hickey RN CCM, Director of Coordinated Care at Lifespan, who was recently notified by NCQA that she successfully passed the NCQA Content Expert exam under the 2014 standards.  Mary participates in many of the CSI-RI Committee meetings and is a valuable resource within CSI-RI's network.

Practice Spotlight: Women's Medical Collaborative 

Kathy Primo RN, Clinical Manager at Women's Medicine Collaborative, recently presented at CSI-RI's Practice Transformation Committee meeting on the work that Women's Medicine Collaborative is doing to put the patient in the center of the practice by implementing a Patient Advisory Council.  

During her presentation Kathy shared how to launch and maintain a Patient Advisory Council within a primary care practice. Benefits of having a Patient Advisory Council include increased understanding, support and respect among patients, family and staff, increased satisfaction for all stakeholders and improved education.  

CMS Policy and Payment Changes Update

The Centers for Medicare and Medicaid Services recently published Revisions to Payment Policies under the Physician Fee Schedule in the Federal Register posting. Lisa Letourneau MD MPH, FACP, Executive Director Maine Quality Counts provided CS-RI with the following summary: 

Primary care and chronic care management

Medicare continues to emphasize primary care by making payment for chronic care non-face-to-face services to Medicare beneficiaries who have multiple, significant, chronic conditions (two or more) beginning in 2015. Chronic care management services include regular development and revision of a plan of care, communication with other treating health professionals, and medication management.

CMS has established a payment rate of $40.39 for CCM that can be billed up to once per month per qualified patient. CMS is finalizing its proposal to allow greater flexibility in the supervision of clinical staff providing CCM services. The proposed application of the "incident to" supervision rules were widely supported by the commenters. Payment for CCM is only one part of a multi-faceted CMS initiative to improve Medicare beneficiaries' access to primary care. Models being tested through the Innovation Center will continue to explore other primary care innovations.

Finally, CMS proposed standards for electronic health records (EHR) - specifically, a 2014- certified EHR. In response to public comments indicating that very few practices have adopted a 2014-certified EHR at this time, CMS will require the version of the certified EHR that is in use on December 31 of the prior calendar year for the EHR Incentive Programs to bill for CCM services.