The BCBSRI Advanced Primary Care Program policies were updated on 28 de julho, 2020 and communicated by email from pcmh@bcbsri.org. These policies are effective 27 de setembro, 2020, and outline the requirements and expectations of all PCMH practices. Adherence to these policies is required to be recognized as a PCMH provider by BCBSRI.
Specific changes and additions to this version of the policies include:
- Nurse Care Manager/Care Coordinator (NCM/CC) recognition requirements and staffing notification process to BCBSRI
- NCM/CC roles and responsibilities:
- Key elements of care management defined by NCQA standards
- Care management areas of focus
- Performance guarantees
- Reporting requirements
- High-risk/high-cost care management
- Chronic condition management
- Wellness/prevention and social determinants of need
- Patient experience
Please direct any questions regarding these changes to pcmh@bcbsri.org. Thank you for your continued commitment to delivering high-quality care.