Clinicians supported by TCPI include primary and specialty physicians, nurse practitioners, physician assistants, clinical pharmacists, and their practices. They need to be on the Physician Quality Reporting System (PQRS) list of eligible participants. (If not currently enrolled in PQRS, HCDI TCPI SAN can assist in facilitating enrollment)
Physicians: Doctors of Medicine, Doctors of Osteopathy, Doctors of Podiatric Medicine, Doctors of Optometry, Doctors of Oral Surgery, Doctors of Dental Medicine, and Doctors of Chiropractic.
Practitioners: Physician Assistants, Nurse Practitioners, Clinical Nurse Specialists, Certified Registered Nurse Anesthetists, and Anesthesiologist Assistants, Certified Nurse Midwives, Clinical Social Workers, Clinical Psychologists, Registered Dietitians, Nutrition Professionals, Audiologists, Advanced Practice Registered Nurses or APRNs.
Therapists: Physical Therapists, Occupational Therapists, and Qualified Speech-Language Therapists.
You cannot participate if you are enrolled in Medicare Shared Savings Programs, Pioneer ACOs, Comprehensive Primary Care Initiative or Multi-Payer Advanced Primary Care Practice programs.
How long is the program?
The grant is funded on a year to year basis for up to four years. Some practices may be engaged for a short time…one year, while others will be engaged for up to three years. The length of participation for each practice will be dependent on the starting phase of the practice as well as the commitment of resources by the practice to transform. This is addressed through a practice assessment survey.
Where will clinician transformation occur in the United States?
TCPI will support clinician transformation in all 50 states.
What capabilities will the practice need to demonstrate in order to be successful in this future state?
CMS has identified five (5) phases of practice transformation that will prepare practices to be successful with advanced payment models. While there are some nuances related to the type of practice being transformed (specialty vs. primary care) the general tenants of the 5 phases are as follows:
Phase 1 – Setting aims and developing basic capabilities
Phase 2 – Reporting and using data to generate quality improvements
Phase 3 – Achieving aims of lower costs, better care, and better health
Phase 4 – Getting to benchmark status
Phase 5 – Practice has demonstrated capability to generate better care, better health at lower costs
What is a Support and Alignment Network?
Support and Alignment Networks 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 help ensure sustainability of these efforts. They especially support the recruitment of clinician practices serving small, rural, and medically underserved communities. The SANs provide support utilizing national and regional professional associations and public-private partnerships.
What is a Practice Transformation Network?
The Practice Transformation Network (PTN) is a limited group of organizations selected by CMS based on a compelling approach for assisting clinicians in transforming their practices and commit to meeting quantifiable goals of TCPI.
The 29 PTN’s are responsible for the following tasks:
Recruiting clinician practices and building strategic partnerships
Serving as champions for continuous improvement, culture change and patient and family engagement
Providing improved clinical practice management training, customized technical assistance, mentoring and coaching support to practicing clinicians
Using quality measures and data for improvement
Practice Transformation Networks
Alabama Physician Alliance
Care Transitions Network
Community Care of North Carolina
Garden State PTN
Great Lakes PTN
Greater New York City PTN
Health Partners Delmarva
LA Care PTN
National Rural ACC PTN
New York State PTN
Northern New England
Practice Innovation Institute
Rhode Island PTN
Southern New England PTN
Southwest Pediatric PTN
VHA-UHC Alliance (Vizient)
Washington Pediatric PTN
How is TCPI related to the requirements of the Medicare Access and CHIP Reauthorization Act (MACRA)?
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.
To learn more about the CMS Transforming Clinical Practice Initiative, please visit: