American College of Physicians: Internal Medicine — Doctors for Adults ®

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Help is on the way for small physician practices

From the January-February ACP Observer, copyright © 2006 by the American College of Physicians.

This month marks the launch of ACP's new Center for Practice Innovation (CPI), an initiative designed to develop, test and disseminate practice redesign strategies for small and midsized physician practices. Those strategies will be geared to improving health care quality and physician reimbursements.

Based in the College's Washington office, the CPI will be a two-year project funded with a nearly $1 million grant from the Physicians' Foundation for Health System Excellence, a nonprofit foundation that targets practice innovations. (The College is also committing $125,000 a year to the project through in-kind contributions.) The CPI is meant to meet a growing need: to help small and medium-sized physician practices achieve significant, sustainable quality improvement.

"Measures and programs that link compensation, public reporting and technology implementation to achieving better clinical outcomes are being introduced at a time of economic stress for most small practices," said Michael S. Barr, FACP, MBA, the College's Vice President for Practice Advocacy and Improvement and the CPI's Director. "There is real concern that without successful models of practice redesign and support, unintended consequences of reduced access, persistent quality gaps and lack of innovation will prevail or even increase."

To devise workable strategies, the CPI will recruit between 25 and 50 practices nationwide from among College members and use those offices as practice-redesign "laboratories" in a pilot project.

Participating offices, which will be chosen later this year based on an application process to be announced in late this month or early February, will receive support from the CPI in the form of practice redesign strategies, guides, educational workshops and ongoing consultation from experts in small-practice economics, health information technology, quality improvement and practice management. According to Dr. Barr, the CPI wants to enlist a range of practices, including small and midsized practices as well as rural and urban ones.

Success of redesign efforts will be assessed according to health outcomes on measures selected by practices from a set approved by the Ambulatory Care Quality Alliance, a national consortium of medical organizations, purchasers and health plans.

In addition to the pilot practice project, the CPI will collaborate with other organizations studying practice redesign, including regional health information organizations. And the CPI intends to broadly share results and lessons learned from the pilot as the project rolls out and when final analysis is completed at the end of the two years.

"Our hypothesis is that the financial concerns of physicians can be addressed through office redesign, attention to quality innovation, enhanced patient satisfaction and practice growth," Dr. Barr said. "We fully intend to measure the financial impact of changes implemented in participating practices."

For more information on the CPI, visit the new center's Web site.

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