Rhode Island patient-centered medical home initiative managed by UMass Medical School incorporates and changes name

December 29, 2014

A Rhode Island primary care initiative managed by UMass Medical School has incorporated into a nonprofit organization and changed its name to the Care Transformation Collaborative of Rhode Island (CTC) as it broadens its focus on health care delivery transformation.

One of the first patient-centered medical home initiatives in the country, it previously was known as the Rhode Island Chronic Care Sustainability Initiative. CTC has been formally incorporated as a nonprofit organization governed by a board of directors led by Thomas A. Bledsoe, MD, FACP.

The Office of Program Development within UMass Medical School’s Commonwealth Medicine division has been providing project management support for the initiative since 2011 under a contract with The Rhode Island Foundation. UMass Medical School’s Office for Program Development staff assists the Rhode Island primary care initiative by providing leadership, project management, program development and subcontract management support.

“We know that primary care needs to address the whole person,” Debra Hurwitz, MBA, BSN, RN, an Office of Program Development senior program development associate and co-director of CTC, said in a release. “We are expanding our focus to include behavioral health and we are piloting Community Health Teams that act as an extension of the primary care team, providing outreach into the community where the patients live and social support to high-risk patients.”

CTC, funded primarily by the commercial health plans that participate in the program, was launched as a pilot project in 2008. The innovative care model began with five primary care practices in 2008 and has expanded to 73 practice sites that provide care to more than 320,000 Rhode Island residents.

“This initiative has become an integral part of our state’s health care delivery system,” Kathleen C. Hittner, MD, Rhode Island health insurance commissioner and co-chairman of the CTC Executive Committee, said in a release. “With insurers investing more in primary care, CTC is finding more efficient and effective ways to deliver the care Rhode Islanders need.”

CTC works to improve quality outcomes, improve patient experiences and reduce the costs of unnecessary hospitalizations, and provides practices with incentives to meet those goals. The organization brings together a multi-payer collaboration of insurers, Medicare and Medicaid to provide team-based, comprehensive and preventive care in a primary care office in which patients work with their health care providers to manage their care. 

Several new CTC programs have been added to improve primary care, including work to better integrate behavioral health care with primary care and the formation of two new Community Health Teams that aim to provide high-risk patients with more support. CTC also is working to strengthen  end-of-life care, patient engagement and activation strategies and broaden the scope to include pediatrics.