The Centers for Medicare & Medicaid Services’ (CMS) Transforming Clinical Practice Initiative (TCPI) is a key component of the new CMS Quality Payment Program. TCPI is uniquely designed to help 140,000 clinicians nationwide transform their practices from quantity of services to quality of care. Nationally, the 29 designated Practice Transformation Networks (PTNs) are charged with coaching and assisting clinicians in developing core competencies that prepare them to participate in Alternative Payment Models (APMs). In late 2015, 13 Quality Innovation Network-Quality Improvement Organizations (QIN-QIOs) were awarded contracts to assist the PTNs operating in their geographic regions. A key role of QIN-QIOs is to assess the clinician practices’ progress through five defined phases of practice transformation, by conducting TCPI baseline assessments and ongoing follow-up assessments for each practice.
From the start, Lake Superior QIN – the Quality Innovation Network-Quality Improvement Organization (QIN-QIO) serving Michigan, Minnesota and Wisconsin – put a high priority on establishing strong working relationships with the six PTNs operating in its region, which currently represent 700 practices and 7,000 clinicians. Building trust and creating ongoing communications were instrumental in the process. Project charters defined expectations and identified shared PTN/QIN-QIO measures. Once relationships were established, the Lake Superior QIN-PTN project teams worked collaboratively to develop efficient practice assessment processes – introductions, warm-handoffs, assessment feedback to PTNs and assessment submission to CMS.
Bill Sonterre, Lake Superior QIN’s TCPI regional lead, says, “The scope of the areas and processes involved in TCPI transformation is extensive. The assessments, which gauge a practice’s baseline, have been eye-opening for many of the practices. The assessments have shown them what they need to better understand in order to achieve transformation goals; the PTNs provide support to enhance processes to effectively achieve transformation strategies.”
Lake Superior QIN’s TCPI team has completed 253 baseline assessments to date, more than double its annual target of 100 baseline assessments. By July 2019, the QIN plans to complete 400 baseline assessments and 3,913 follow-up assessments. To achieve these ambitious targets, the current plans call for Lake Superior QIN to complete 100 percent of baseline and follow-up assessments for five of the PTNs, and a large percentage of the assessments for the sixth PTN. The strategy also calls for reaching out and supporting any new PTNs that may start operating in the three-state region.
Taking innovative steps, Lake Superior QIN is integrating TCPI with other QIN project work as budgets allow. Sonterre adds, “We’re getting a better feel for what each PTN is focusing on, so we can help the practices with quality improvements and meeting their transformation goals.”