Acronyms and Definitions
- PTN: Practice Transformation Networks (PTN) formed by group practices, healthcare systems, and others that join together to serve as trusted partners to provide clinician practices with quality improvement expertise, best practices, coaching, and help as they prepare and conduct clinical and operational practice transformation.
- SAN: Support and Alignment Networks (SANs) formed by professional associations and others that align their memberships, communication channels, continuing medical education credits, and other work to support the PTNs and clinician practices.
- TCPI: The Transforming Clinical Practice Initiative (TCPI) model will test whether a three-pronged approach to national technical assistance will enable the large-scale transformation of thousands of clinician practices to deliver better care and result in better health outcomes at lower costs for Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) enrollees.
A: The Transforming Clinical Practice Initiative (TCPI) model will assist clinicians in improving the way they deliver care by providing technical assistance support for integrating quality and process improvement, and by building on and spreading existing change methodologies, practice transformation tools, published literature, and technical assistance programs. Clinicians that will be supported by TCPI include primary and specialty physicians, nurse practitioners, physician assistants, clinical pharmacists, and their practices.
To achieve these goals, TCPI funds two types of collaborative networks—Practice Transformation Networks and Support and Alignment 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 healthcare system.
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.
A: CMS is providing four types of support to assist the agency in the administration and testing of this model:
- Implementation: Facilitation and support of model project management by providing TCPI-wide program management services to support CMS's ability to understand the practice transformation network (support and alignment network and TCPI support contractor progress toward achieving the objectives and requirements defined in their respective cooperative agreements and task orders).
- Development, Management, and Improvement: Support for national quality improvement faculty and leadership; technical assistance for TCPI participating clinicians, practice transformation networks, and support and alignment networks; knowledge management, learning, and diffusion; and weekly national webinars.
- Data Support and Feedback: Creation of a hub for TCPI data collection and support of practice transformation networks and support and alignment networks to provide aggregate reporting of results to CMS; development of feedback reports using PTN and SAN self-reported data and other CMS data (e.g, Physician Quality Reporting system, Meaningful Use data, and other information).
- Evaluation and Analysis: Independent on-going evaluation for TCPI. Utilization of self-reported data and other CMS data to evaluate the effectiveness and impact of the TCPI Model.
A: Through the implementation of TCPI, practice transformation networks will provide technical assistance and peer-level support to assist clinicians in delivering care in a patient-centric and efficient manner. PTNs will support clinicians in identifying and engaging with national improvement leaders to implement and continuously refine their practices. The PTNs will establish and further develop relationships with other public and private entities.
A: Specific work support and alignment networks will be doing include, but is not limited to: establishing collaboratives for emergency clinicians to address appropriate utilization of tests and procedures; forming psychiatry/primary care collaborations for common mental health disorders (depression and anxiety) to allow patients to remain with primary care physicians; recruiting clinicians to participate in practice transformation networks; training patients to be effective partners with clinicians in quality improvement; provide continuing medical education (CMEs) and maintenance of certification credit for TCPI participation; and inviting PTN practices to present at members' annual meetings and/or webinars.
A: Patients and their families will benefit from TCPI as clinicians and their practices improve the way they deliver care. Clinicians will focus on measuring patient health outcomes and integrating practices that have been proven to assist in improving care. As clinicians improve their communication and related processes between primary and specialty care practices, they will facilitate change and improvements that are planned to reduce hospitalizations and overutilization of testing and other services.
A: TCPI will support clinician transformation in all 50 states.
A: The five Phases of Transformation are descriptive milestones that each PTN and SAN will move their clinicians through in order to meet the goals and aims of the model. The stages in which the PTNs and SANs are operating include:
- Setting aims and developing basic capabilities
- Reporting and using data to generate improvements
- Achieving aims of lower costs, better care, and better health
- Getting to benchmark status
- The practice has demonstrated capability to generate better care, better health at lower cost
A: TCPI is a four year model test. As clinicians progress through the TCPI five Phases of Transformation, they will be better positioned to meet and succeed under delivery system reform efforts such as those that are part of MACRA, such as the Merit-Based Incentive Payment System and qualified Alternative Payment Model provisions.
A: The Practice Transformation Networks will provide "boots on the ground" support to coach, mentor, and assist clinicians in developing core competencies to assist them in moving through various phases of healthcare transformation. The Support and Alignment Networks will provide a system of national, state, and regional professional associations and other supports that align programs and platforms of continuing medical education, maintenance of certification, patient and family engagement, and other work with the overarching aims of the TCPI. These networks will support clinician members and play an active role in the alignment of new and shared learning.
A: The performance periods for the PTNs and SANs are from October 2015-September 2019.