OHIC Update: RI Patient-Centered Medical Home 2020 Performance Improvement Reporting Requirements 

RI Health Insurance Commissioner Marie Ganim, PhD, has provided guidance for primary care practices on the changes to the 2020 meaningful performance improvement requirements in response to the impact of COVID-19. A practice seeking OHIC PCMH recognition status has historically been required to meet OHIC’s definition of demonstrating “meaningful performance improvement,” meaning performance is at or above a predefined benchmark or performance has improved by at least three percentage points over one or two years. For reporting in 2020, however, OHIC has decided to move all measures to reporting-only status as it anticipates that COVID-19 will have a significant impact on quality measure performance. Therefore, practices only need to report performance on the appropriate measures from the PCMH Measure Set in order to meet this component of the PCMH definition. As a result, OHIC will use data from the 10/1/2018 – 9/30/2019 performance period to assess improvement for the 10/1/2020 – 9/30/2021 performance period. 

Primary care PCMH reports are due October 15 and include: a) 2020 OHIC Cost Management Survey and b) 2020 PCMH Quality Measurement and Integrated Behavioral Health Reporting Survey. In 2020, practices will need to report on the following measures for the 10/1/2019-9/30/20 using the updated measurement specifications. Lead screening has been added as a new measure for pediatric practices; however, practices will not need to submit data for “Lead Screening in Children” to OHIC. With practice permission (and practice provision of KIDSNET practice ID), RIDOH will provide OHIC with practice reports for the 10/1/2019-9/30/2020 measurement year for the measure. 

Questions? Visit OHIC’s PCMH webpage or contact Cory King (704-242-2292 or Cory.King@ohic.ri.gov).