Transforming Clinical Practice Initiative

The Transforming Clinical Practice Initiative is designed to help clinicians achieve large-scale health transformation. The initiative is designed to support more than 140,000 clinician practices over the next four years in sharing, adapting and further developing their comprehensive quality improvement strategies. The initiative is one part of a strategy advanced by the Affordable Care Act to strengthen the quality of patient care and spend health care dollars more wisely. It aligns with the criteria for innovative models set forth in the Affordable Care Act:

• Promoting broad payment and practice reform in primary care and specialty care.
• Promoting care coordination between providers of services and suppliers,
• Establishing community-based health teams to support chronic care management, and
• Promoting improved quality and reduced cost by developing a collaborative of institutions that support practice transformation.

Background

Since the launch of the Affordable Care Act, CMS has launched numerous programs and models to help health providers achieve large-scale transformation. Programs and models, such as the Hospital Value-Based Purchasing Program, Accountable Care Organizations, and the Partnership for Patients initiative with Hospital Engagement Networks, are striving to help clinicians and hospitals move from volume-based towards patient-centered quality health care services. This has resulted in fewer unnecessary hospital readmissions, reductions in healthcare-associated infections and hospital-acquired conditions, and improvements in quality outcomes and cost efficiency.

To date, there has been no large–scale investment in a collaborative peer-based learning initiative designed as an investment that ensures that clinicians who participate will be part of leading and creating positive change for the entire health care system. CMS estimates that only about 185,000 of the nation’s clinicians currently participate in existing programs, models, and initiatives that facilitate practice transformation.

The Transforming Clinical Practice Initiative is one of the largest federal investments uniquely designed to support clinician practices through nationwide, collaborative, and peer-based learning networks that facilitate large-scale practice transformation.

Initiative Details

Practice Transformation Networks

The Practice Transformation Networks are peer-based learning networks designed to coach, mentor and assist clinicians in developing core competencies specific to practice transformation. This approach allows clinician practices to become actively engaged in the transformation and ensures collaboration among a broad community of practices that creates, promotes, and sustains learning and improvement across the health care system. The following organizations are the Practice Transformation Networks:

• Arizona Health-e Connection
• Baptist Health System, Inc.
• Children's Hospital of Orange County
• Colorado Department of Health Care Policy & Financing,
• Community Care of North Carolina, Inc.
• Community Health Center Association of Connecticut, Inc.
• Consortium for Southeastern Hypertension Control
• Health Partners Delmarva, LLC
• Iowa Healthcare Collaborative
• Local Initiative Health Authority of Los Angeles County
• Maine Quality Counts
• Mayo Clinic
• National Council for Behavioral Health
• National Rural Accountable Care Consortium
• New Jersey Innovation Institute
• New Jersey Medical & Health Associates dba CarePoint Health
• New York eHealth Collaborative
• New York University School of Medicine
• Pacific Business Group on Health
• PeaceHealth Ketchikan Medical Center
• Rhode Island Quality Institute
• The Trustees of Indiana University
• VHA/UHC Alliance Newco, Inc.
• University of Massachusetts Medical School
• University of Washington
• Vanderbilt University Medical Center
• VHQC
• VHS Valley Health Systems, LLC
• Washington State Department of Health

Support and Alignment Networks

The Support and Alignment Networks will provide a system for workforce development utilizing national and regional professional associations and public-private partnerships that are currently working in practice transformation efforts. Utilizing existing and emerging tools (e.g., continuing medical education, maintenance of certification, core competency development) these networks will help ensure sustainability of these efforts. These will especially support the recruitment of clinician practices serving small, rural and medically underserved communities and play an active role in the alignment of new learning. The following organizations are the Support and Alignment Networks:

• American College of Emergency Physicians
• American College of Physicians, Inc.
• HCD International, Inc.
• Patient Centered Primary Care Foundation
• The American Board of Family Medicine, Inc.
• Network for Regional Healthcare Improvement
• American College of Radiology
• American Psychiatric Association
• American Medical Association
• National Nursing Centers Consortium

Support and Alignment Networks 2.0

A second round funding opportunity announcement of the Support and Alignment Networks (2.0) was announced on June 10, 2016. This opportunity will provide up to $10 million over the next three years to leverage primary and specialist care transformation work and learning that will catalyze the adoption of Alternative Payment Models at very large scale, and with very low cost. The Support and Alignment Networks 2.0 represents a significant enhancement to the TCPI network expertise and will help clinicians prepare for the proposed new Quality Payment Program, which CMS is implementing as part of bipartisan legislation Congress passed last year repealing the Sustainable Growth Rate.

Through this initiative, the Support and Alignment Network 2.0 awardees will identify, enroll, and provide tailored technical assistance to advanced clinician practices in order to accelerate transformation and diffuse this learning throughout the TCPI initiative. Support and Alignment Network 2.0 awardees’ activities, coaching, and technical assistance should result in the rapid transition of practices through five phases of transformation:

• Set aims
• Use data to drive care
• Achieve progress on aims
• Achieve benchmark status
• Thrive as a business via pay-for-value approaches

The period of performance for the Support and Alignment Networks 2.0 is September 2016 through September 2019. The period of performance includes three 12-month budget periods. Support and Alignment Networks must achieve reasonable progress to the aims of the initiative as supported by their own proposed specific targets and milestones. Continued funding is contingent on adequate progress, compliance with the terms and conditions of the previous budget period, and the availability of funds.

For additional information, please contact transformation@cms.hhs.gov

Rapid Practice Innovation (RPI) 

If your organization is participating in a TCPI Network or just looking to improve. ERM has a solution that is guaranteed to deliver results in just 24 weeks. 

Rapid Practice Innovation is an evidence based practice transformation program that ensures your organization is “risk ready.” Over the last 4 years, we have worked with medical practices, IPAs, MSOs FQHCs, health alliances, rural health networks and health plans to improve the delivery of care from the initial point of contact and sustain that change through RPI.

Two RPI Tracks for 2017 and 2018:

• 24 Week Practice Transformation - Our proprietary 24 week curriculum re-designs the primary care office from the ground up to ensure success in the new world of value-based reimbursement. 

• 52 Week "Risk Ready" Practice Transformation - This track combines the 24 week curriculum followed by 28 weeks of monitoring and follow-up for certification. Practices who successfully complete both the 24 week curriculum and the 28 week post-transition follow-up will be awarded a “Risk Ready” Certificate. 

Email Kameron Gifford at kgifford@ermconsultinginc.com for more information.