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CMS Initiative to Transform Clinical Practice

By: Kathleen “Kitty” Juniper, Esq.

Calling Practice Groups, Nurse Practitioners, Physician Assistants, Primary Care MDs, Specialty MDs, Professional Associations, Evidence-Based Medicine Service Providers and More …

Practitioners who want to partner with other health care professionals to improve quality outcomes may find financial help through the latest Centers for Medicare & Medicaid Services’ (CMS) initiative. CMS is continuing its mission to push health care communities toward cooperative efforts in achieving the Affordable Care Act’s goals with its announcement on October 23, 2014, of the Transforming Clinical Practice Initiative (TCPI). To assist with improving health outcomes at lower costs for Medicare, Medicaid and Children’s Health Insurance Program enrollees, the CMS Innovation Center expects to award participants from $2 million to $50 million each to cover a four-year period of performance.

Unlike other funding programs, this initiative focuses specifically on clinical practices (including non-physician practices), intending to transform them to high quality, evidence-based medical practices, through participation in Practice Transformation Networks (PTN). The TCPI also aims to move clinicians further toward value-based payment models containing incentive programs and performance-based rewards.  The TCPI includes PTNs and Support and Alignment Networks (SANs).

PTNs are formed by group practices (primary care physicians, specialty physicians, nurse practitioners, physician assistants, clinical pharmacists), who work together to assist clinical practices through their quality improvement and best practices expertise, coaching and assistance.

SANS include professional associations, specialty societies, organizations involved in generating evidence-based clinical practice guidelines and other groups that support the PTNs through continuing medical education, memberships, communications and other activities.

The CMS cooperative agreements for PTNs and SANS can be found here.

Letters of intent are due by November 20, 2014.