The patient-centered medical home (PCMH) is not a place - it is a model of primary care that promotes accessible, comprehensive, coordinated care and encourages patients and families to be actively involved in health care decisions. The model is patient-focused and looks at prevention, overall wellness and appropriate treatment.
Patient-centered medical home teams are led by a qualified provider that the patient chooses. This provider coordinates with a team of people who know the patient and work together to provide the best possible care.
Convened in 2008 by the Office of the Health Insurance Commissioner (OHIC) and the Executive Office of Health and Human Services (EOHHS), CTC-RI began with five pilot sites and has grown to 80 primary care practice sites, including internal medicine, family medicine, and pediatrics, through PCMH-Kids. Currently, approximately 350,000 Rhode Islanders receive their care from CTC-RI practices. CTC-RI anticipates continued expansion in support of state leadership goals to increase the number of PCMHs in the state.
In 2015 CTC-RI incorporated as a 501c3, establishing a Board of Directors as its governing body. CTC-RI is supported by funding from public and private payers in Rhode Island, along with grant funding from government and non-governmental sources.
The health plans also provide direct support for the practices through the Common Contract, an agreement negotiated between the health plans and the participating practices under the auspices of OHIC and EOHHS. The Contract provides supplemental per member per month payments designed to drive practice transformation and quality improvement. These payments allow the practices to make structural enhancements to apply for national PCMH recognition, hire on-site care management/coordination to impact the patients with the highest needs, and enhance data capabilities to manage and improve population health.
PCMHs improve health outcomes, help patients have better care experiences and reduce expensive, unnecessary hospital and emergency department visits. Here in Rhode Island, CTC-RI practices are showing that effective PCMHs truly make a difference for patients, providers and payers, as well as the entire health care system.