Update from Practice Reporting and Transformation Committee Meeting

Adult and pediatric practices met on October 30 to review quarterly clinical quality, utilization performance information and PCMH Kids nurse care manager/care coordinator engagement rates with children and families that are considered to be "at risk."

On October 15, the RI Office of the Health Insurance Commissioner (OHIC) issued updated measurement specifications that practices will be expected to use when they report on their clinical performance to OHIC next year (10/15/20). From OHIC's point of view, the depression screening and follow-up measure will require care plan or additional evaluation and the PHQ-9 will not be considered as "follow-up." Because this is a significant change to the measure, OHIC will consider the practice clinical quality results for depression screening and follow-up as baseline information for 10/15/20. 

Adult practices participating in the CTC-RI contract will be ending their 3-year contract in June 2020 and will be eligible for incentive payment based on meeting performance standards either by Method 1 (meeting the standard) or by Method 2 (improvement method). The CTC-RI Data and Evaluation Committee has decided that practices can continue to use the measurement specifications dated 1/2019 consistent with what has been outlined in the common contract agreement. From CTC-RI's point of view, performance data using the measurement specifications from 1/2019 will be used for determining eligibility for incentive payment. The CTC-RI Performance Standards have been updated to reflect this information.

During this interim period, practices will want to start working on what they will need to do differently to meet upcoming 2020 OHIC expectations.