OHIC Practice Audit on Cost Management Strategies

In 2016, 126 primary care practices submitted Self Attestation Cost Management Reports to OHIC as part of qualifying criteria for patient centered sustainability payments. The Rhode Island 2017-2018 Care Transformation Plan Adapted by Health Insurance Commissioner Kathleen C. Hittner on 1/27/17 identifies activities in 2017-2018 that will help advance PCMH transformation by RI primary care practices.  An identified activity is obtaining audit data on Cost Management Strategies.  The purpose of the audit is to ensure that cost management strategy data supplied by practices are accurate and consistently reported and to inform future data collection

CTC-RI will initially select a random sample of all PCMH practices that submitted cost management strategy data and  audit (10%) of the practices. CTC-RI will report on the initial audit findings to the OHIC sub-committee for further discussion and decision for auditing more practices (up to 30%). The auditing process will start in March 2017.  More information can be found here.