Rhode Island Primary Care Trust: A strategy for neighborhood transformation

Robust primary care, particularly following the patient-centered medical home (PCMH) model, is a proven method for improving quality of care and reducing costs (largely through reduced hospital and ED utilization).

The Rhode Island Department of Health is developing a mechanism for a network of Neighborhood Health Stations (or Stations) that will build on current PCMH initiatives in Rhode Island and improve how primary care is delivered.

Every Rhode Island community of 10,000 will have a Station to provide 90% of the health services communities need—including medical care, behavioral health, oral health, physical therapy, home health, chronic disease self-management, and emergency medical services—so that 90% of Rhode Islanders use their community’s Station.

Funding from all payers will be consolidated into a Primary Care Trust and provide capitated rates to the Stations. The Trust will provide tiered incentives when Stations achieve certain outcomes, and will give higher payments to Stations offering expanded hours, increased breadth of services, and active management of community health.

Through community based participatory research, each Station will determine the services it should provide based on the needs of its community. Stations will thus be positioned to advocate for the population health needs of their communities, an essential role as Rhode Island does not have local public health departments.