Care Transformation Collaborative of Rhode Island (CTC)

Program Location: 
Providence, RI
Number of Practices: 
Payer Type: 
Blue Cross Blue Shield Rhode Island
Neighborhood health Plan
Tufts Health Plan
United Health Plan

Reported Outcomes


Launched in 2008 by the Office of the Health Insurance Commissioner, the  Care Transformation Collaborative of Rhode Island (CTC) (formerly the R.I. Chronic Care Sustainability Initiative (CSI-RI)) brings together key health care stakeholders to promote care for patients with chronic illnesses through the patient-centered medical home (PCMH) model. CTC-RI began with five pilot sites in 2008, added eight sites in 2010 and another three sites in October 2012. Currently, CTC includes 43 primary care practices with 73 total practice sites, providing more than 320,000 Rhode Islanders with access to a patient centered medical home. Over the next five years, 20 practices will be added each year, with the goal of providing over 500,000 Rhode Islanders with access to a PCMH. 


Payment Model: 

The administration of the project is supported through the Rhode Island Foundation and led by a team from the University of Massachusetts Medical School. Support for the practices comes through the common contract, an agreement negotiated between the health plans and the participating primary care practices under the auspices of OHIC. The contract calls for payments to supplement the traditional fee-for-service structure, providing practices with per member per month payments designed to drive practice transformation and quality improvement. These supplemental payments allow the practices to make structural enhancements, including the addition of a Nurse Care Manager, who oversees care coordination efforts, as well as an analytical structure to use electronic medical records to track patient data. CSI-RI is supported by funding from public and private payers in Rhode Island, along with grant funding from government and non-governmental sources. Click here for more information.

Fewer ED / Hospital Visits: 

CTC-RI 2014 Annual Report (May 2015)

  • 7.2% reduction in hospital admissions in most experienced CTC-RI practices

CSI-RI 2013 Annual Report (May 2014)

  • More experienced CSI-RI practices saw reduced inpatient hospitalization, while the comparison group (primary care practices that are not CSI-RI patient-centered medical homes) experienced an increase

JAMA Internal Medicine (November 2013)

  • 11.6% reduction in ambulatory care-sensitive emergency department visits
  • Fewer overall ED visits, inpatient admissions and ambulatory care sensitive inpatient admissions (not statistically significant)
Improved Health: 

JAMA Internal Medicine (November 2013)

  • improvements across diabetes cares measures in PCMHs vs control groups (not statistically significant) 

CSI-RI 2013 Annual Report (May 2014)

  • practices collectively met every targeted patient heath outcome, including areas of weight management, diabetes, high blood pressure and tobacco cessation, and practices are showing improvement over time in all of the targeted areas

Improved Patient/Clinician Satisfaction: 

CTC-RI 2014 Annual Report (May 2015)

  • CTC-RI practices reported higher patient experience compared with other MAPCP states

CSI-RI 2013 Annual Report (May 2014)

  • CSI-RI practices received increased, positive patient experience ratings, including access to care, communication with their care team, office staff responsiveness, shared decision making, and self-management support

Other Outcomes: 

CSI-RI 2013 Annual Report (May 2014):

  • Primary care spending increased by 37% between 2008-2012
  • Total medical spending fell 14%
  • Non-FFS investments continue to increase

**Data on the CSI-RI through October 2013 

Last updated February 2019
Go to top