Clinical Strategy Committee focuses on PCP/Specialist Collaboration, New Provider Orientation, and Medicaid Redetermination

The CTC-RI’s March Clinical Strategy Committee Meeting provided an update on system of care PCP/Specialist Collaboration progress using the AAMC CORE (Coordinating Optimal Referral/eConsult) approach. Steven Lampert, MD, MBA, President of Lifespan, Paul Larson, MD, MBA, Chief of Primary Care with Lifespan and John Minichiello, President Integra Community Care Network ACO, presented on their progress to date with educating and engaging PCPs and specialists around enhanced referrals and econsults. Scott Shipman, MD, MPH, Director of Clinical Innovations and Director of Primary Care Initiatives, Association of American Medical Colleges provided guidance on Year 1: Implementation and Year 2: Scaling and Sustaining the Model and Measuring Impact. The Primary Care/Specialist Oversight Committee (with Co-Chairs John Minichiello and Cathleen Newman, BCBSRI) will work to improve coordination and alignment between primary care and specialists using a multi-pronged approach. Lifespan will be rolling out their referral process in May, with pediatric/adult GI and psychiatry while Integra is starting with cardiology. There was also much interest in the continued rollout of specialist waves and expansion to PCPs not on EPIC to determine if the statewide HIE, CurrentCare, could be used to assist in e-consults/enhanced referrals.

In April, there was a focus on new provider orientation and current plans to lessen the impact of Medicaid redetermination when the public health emergency ends. Dr. Michelle Anvar, Brown Medicine and Dr. Andrew Saal, Providence Community Health Centers (PCHC) shared their organizational approaches to new provider orientation and the impact on long-term retention. ACOs with smaller practices were encouraged to consider how they may provide support in that process. Nicole Nelson reviewed the comprehensive approach that RI Medicaid is taking to minimize insurance coverage disruption once redetermination begins. Alice Msumba for Tufts Health Plan and Dr. Chris Ottiano from NHPRI spoke about their approaches to support members, and Lori Whittemore and Zumela Gonzales discussed the outreach and educational efforts being undertaken at PCHC. To view the recording, find additional resources, and claim CME credit, click on this link: CME coursework.