New CTC-RI Practice Information

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2020 Transition of Care from Adolescence to Adulthood Quality Improvement Program Resources:


2020 Pharmacy Quality Improvement Initiative

2019 Pediatric IBH Program Resources:

Binder Content
KIDS COUNT Children's Mental Health Fact Sheet 2019

2019 Integrated Behavioral Health Expansion Resources:


2019 CTC-RI Multi-Payer 2019 Pediatric Expansion of the Patient-Centered Medical Home Kids Iniative - Resources:

Sample Nurse Care Job Description (for reference)
Standardized Learning Options (Pediatrics)
PCMH Kids High Risk Framework work tool
PCMH Kids High Risk Report Out
How to Access High Risk Reports from Health Plans
Generic Huddle Form
Medical Home Portal (PCMH Kids only)
Cedar Fact Sheet
Programs for Children
Early Intervention Fact Sheet
Respite Fact Sheet
Personal Assistance Services and Support (PASS) Fact Sheet
Applied Behavior Analysis (ABA) Therapy Fact Sheet
Kids Link
BEAH Parent Brochure
Pediatric Quality Measure Strategy Check List
Portal Procedure Overview
Definition of Stable Data
Sample: Access Improvement Worksheet
Sample Policy: Patient Communication
CAHPS Survey Child Version 3
Sample Data Stat Information Package: include update from Data Stat
Sample Template for Uploading Patient Panel
PCMH Orientation Checklist
Sample Policy: Outbound Referrals
Sample Specialists Co-Management Agreement
PediPRN Letter
Sample Transition of Care Policy
Medication Reconciliation Guide for Health Care Professionals
CTC-RI Practice Transformation Program
Current PCMH Kids Practices
NCQA Resources
New Practice Assessment
PCMH Suggested Path to Recognition
PCMH Annual Reporting Requirements
2019 OHIC PCMH Frequently Asked Questions
Sample After Hours Policy

2017 Adult and Pediatric Common Contracts and other Resources

December 2018 CTC/OHIC Measure Specifications - Adult and Pediatric Practices

Reminder for December 2019 and January 2020

Transition of Care Policy

NCM/CC Newsletter Article with registration links for GLearn and ECHO Programs

PCMH Kids High Risk Framework Assessment and Work Plan Tool

BCBSRI 2019 Advanced Primary Care Policy Overview

Care Management and Support

NCM/CC Application-Participative Agreement

Develop High Risk Registry and Reportable Fields for Care

Basic Shared Care Plan

AAP Care Plans

BH Care Plan


Reminder on CTC-RI January 2019 Adult Service Delivery Requirements:
CTC management team has outlined a summary document and resource information to assist you with meeting the CTC 2018 February and March Adult Service Delivery Requirements.  Practices facilitators will be working with your practice to assist you with meeting the requirements. 
CTC-RI January 2019 Adult Service Delivery Requirements Summary Document and Resource Information

PDSA Worksheet for Testing Change
Provider File Timeline
Open Access and Continuity of Care and Before and After Visit Protocol
Sample High-Volume Specialist Compact
Sample Behavioral Health Compact/Collaborative Care Management
Sample NCQA Work Plan

Adult Practices (January CPC+ Expansion):
2017 CTC Common Adult Full Contract January 2017
Nurse Care Manager Job Description
CTC Adult Service Delivery Requirements and Provider Reports January 2017
Performance Incentive Adult January 2017
Milestone Summary

Adult Practices (July Expansion):
2017 CTC Common Adult Contract July 2017
2017 CTC Common Adult Full Contract July 2017
Nurse Care Manager Job Description
CTC Adult Service Delivery Requirements and Provider Reports July 2017
Performance Incentive Adult July 2017
Milestone Summary

Pediatric Practices (July Expansion):
2017 CTC Common Pediatric Contract July 2017
2017 CTC Common Pediatric Full Contract July 2017
Care Coordination Roles and Responsibilities
PCMH-Kids Services Delivery Requirements and Provider Reports July 2017
Performance Incentive Pediatric July 2017
Milestone Summary


Moms PRN

Alternative Reporting Excel Template

Measure Specification Document

Orientation Binders

CTC-RI Orientation Binder-July 2017
CTC-RI Orientation Binder - January 2017
Updated Service Delivery Document 6.30.17

CTC-RI Orientation Binder - December 2014
CSI-RI Orientation Binder - August 2013
This binder provides valuable and current information for all CSI practices.

CSI-RI Orientation Videos

CSI-RI New Practice Orientation Full Session

CSI-RI New Practice Orientation Break-out Session on Practice Transformation with Christine Johnson

CTC HR Resources

CTC-RI SMART Goals Training

Strategic Plan Dashboard

CTC-RI Accomplishments presented to Board Feb 2019

CTC 2019 strategic objectives, accomplishments and next steps

CTC-RI Implementation Planning Tool Dashboard 2019_07_25 Q1

Diabetes Health Equity Challenge 2020

CHT, CCE, HEZ Contact List 

Diabetes Health Equity Challenge Call for Applications 2020

Our Mission

The mission of the Care Transformation Collaborative is to lead the transformation of primary care in Rhode Island in the context of an integrated health care system; and to improve the quality of care, the patient experience of care, the affordability of care, and the health of the populations we serve.