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R.I. pushes insurers to PCMHs

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Kathleen Hittner, the Rhode Island health insurance commissioner, announced an overhaul of the office’s “affordability standards.”  The change will require insurers to increase the percentage of their primary-care networks  running as “patient-centered medical homes (PCMHs)” by 5 percentage points in 2016.

It’s  mostly part of an effort by the new governor, Gina Raimondo, to bring the Medicaid costs under control.

The state announced:

“The Care Transformation Plan requires insurers to increase the percentage of their primary care network functioning as a PCMH by 5 percentage points for 2016 and sets a target of 80% of Rhode Island primary-care clinicians practicing in a PCMH by 2019. The Alternative Payment Methodology Plan establishes payment reform targets for commercial insurers and sets a target for at least 30% of insured medical payments to be made through an alternative payment model by 2016. The payment reform targets will increase the use of payments that emphasize value rather than volume and include efficiency-based global and bundled payment models, as well as payments based on quality performance.”

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