Transforming Clinical Practice Initiative
The Centers for Medicare & Medicaid Services today launched a new innovative model to support clinicians in achieving large-scale health care transformation. The Transforming Clinical Practice Initiative will provide up to $840 million over the next four years to support 150,000 clinicians in sharing, adapting and further developing comprehensive quality improvement strategies, which are expected to lead to greater improvements in patient health and reduction in health care costs.
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 helping clinicians and hospitals move from volume-based practices towards value-based and 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.
The Affordable Care Act has helped reduce hospital readmissions in Medicare by nearly 10 percent between 2007 and 2013 – translating into 150,000 fewer readmissions – and quality improvements have resulted in saving 15,000 lives and $4 billion in health spending during 2011 and 2012. Additionally, national reductions in adverse drug events, falls, infections, and other forms of hospital-induced harm are estimated to have avoided 518,000 patient injuries.
To date, there have only been small-scale investments in a collaborative peer-based learning initiative. CMS estimates that about 185,000 clinicians currently participate in existing programs, models, and initiatives that facilitate practice transformation. This represents only 16 percent of the nation’s one million Medicare and Medicaid providers. While this is an increase over previous years, there is much more work to be done.
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 practice transformation.
Through this initiative, CMS will invest in the creation of evidence-based, peer-led collaboratives and practice transformation networks to support clinicians and their practices as they move towards and navigate a value-based health care system that rewards value and high quality care.
The initiative 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.
The initiative leverages the preliminary success of existing programs and models that have proven effective in achieving transformation, specifically in quality improvement, health care collaborative networks, and financial and program alignment. It identifies existing successful healthcare delivery models and works to rapidly spread these models to other health care providers and clinicians.
CMS will award cooperative agreement funding for two network systems under this initiative: Practice Transformation Networks, as well as Support and Alignment Networks.
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.
CMS will award cooperative agreement funding to successful applicants who have pre-existing relationships with multiple clinician practices (primary care and/or specialists) that include data sharing capabilities. Successful applicants will collaboratively lead clinicians and their practices through the transformation process, achieve the initiative’s goals, and ensure that clinicians and their practices can maintain and sustain these activities in a dynamic care delivery system.
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.
CMS will award cooperative agreement funding to successful applicants that may include eligible medical professional associations, specialty societies, and other organizations that are involved in aligning their programs with the aims of the initiative; generating evidence-based guidelines for clinical practice; promoting measurement for improvement; supporting members and practices in work to reduce unnecessary testing and procedures; and, effectively incorporating safety and patient and family engagement.
Applications will be accepted from eligible applicants for both cooperative agreement funding opportunities starting October 23, 2014. Applicants are encouraged, but not required, to submit a letter of intent by November 20, 2014. Applications are due to CMS no later than January 6, 2015. Applications received after this date will not receive consideration for the cooperative agreement funding opportunities.
CMS anticipates announcing awards in Spring/Summer 2015.
For More Information
For more information, please refer to the Transforming Clinical Practice Initiative funding opportunity announcement found at: http://innovation.cms.gov/initiatives/Transforming-Clinical-Practices/.
For specific questions not answered in this fact sheet or funding opportunity announcement, please send an email to firstname.lastname@example.org