Rhode Island RHTP APM Incentive Payment Application

Summary

the state’s rural and island communities. The RHTP APM Incentive Payment Application is for Initiative 11, which accelerates provider participation in advanced alternative payment models (APMs) with components including incentive payments, technical assistance, and provider transformation funds. This application is solely for the APM Incentive Payment Program (Year 1 of 5). Eligible rural acute care hospitals and primary care practices, including those under parent organizations, may apply for incentive funding by committing to specific APM requirements (detailed by provider entity type) and cost/quality reporting. Approved providers will execute a performance agreement before receiving payments. Annual reapplication is required; additional details on eligibility and commitments are in the program FAQ.

Eligibility

Eligible applicants include rural acute care hospitals and primary care practices located within Rhode Island that commit to the program’s specific value-based payment and reporting requirements. Rural eligibility is determined using a functional, access-based methodology: providers must either meet the federal definition under 42 U.S.C. § 1397ee(h)(3)(D), be located in one of the state's 18 rural municipalities or Narragansett Indian Tribe territory, have at least 18% of patients residing in rural ZIP codes, hold a state-designated catchment/regional responsibility, or provide essential/unique services accessed by rural residents. Parent organizations may apply on behalf of owned/affiliated practices or hospitals but may only receive payment for those entities.

Requirements Checklist

• Applicants must: (1) Demonstrate commitment to APM participation as specified for their entity type (primary care practices or hospitals, e.g., executing or committing to particular APM contracts with downside risk); (2) Provide required cost and quality reporting per program details; (3) Download, complete, and upload the Provider Application Workbook for all applying entities; and (4) Submit through an authorized organization representative. Participation agreements are executed for approved providers prior to payment. Annual reapplication and compliance with updated program requirements are necessary for continued funding.