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BCBSRI Advanced Primary Care Program policies
Blue Cross Blue Shield of Rhode Island·RI · Family Medicine, Internal Medicine, General Practice +1 more·Physician
Effective date
Sep 27, 2020
We identified it
Jun 19, 2026
Summary
BCBSRI updated their Advanced Primary Care Program policies effective September 27, 2020, establishing new requirements for Patient-Centered Medical Home (PCMH) recognition. The changes focus on Nurse Care Manager/Care Coordinator staffing, roles, responsibilities, and reporting requirements for primary care practices participating in the program.
Action Required
Primary care practices seeking PCMH recognition must ensure compliance with new NCM/CC staffing notification process to BCBSRI, implement updated care management protocols per NCQA standards, and establish reporting processes for high-risk/high-cost patient management and chronic condition care. Contact pcmh@bcbsri.org for specific implementation guidance.