Transform to get ahead of the payment reform curve


Value-based payments are on the horizon, and practices need to prepare. There are very worthwhile reasons for getting ahead of the payment reform curve. There are also excuses not to do so.

“Practice transformation is too much work.”

“Who has time to focus on making changes? We can barely get through the hoops that already exist.”

But the Centers for Medicare & Medicaid Services (CMS) announced in September 2015 the rollout of its new Transforming Clinical Practice Initiative (TCPI), which provides funds to both Practice Transformation Networks (PTNs) and Support and Alignment Networks (SANs). Joining a PTN will give a practice a leg up in the transformation game.

PTNs are regional peer-based learning networks made up of a broad community of practices, all engaged in the work of medical practice transformation. Practices that join a PTN will get technical support that makes them likely to be more successful under the impending new payment reform models to be implemented under the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015.

As part of a PTN, practice owners will complete a standardized practice assessment tool that will show them where a practice has areas for improvement and allow them to develop a customized plan that will guide their unique practice through the steps still needed to be prepared to thrive in a value-based payment environment.

As part of a PTN, practice owners will have access to practice transformation coaches, consultants, expert faculty, and peers who have been or are going through exactly what they are. Additionally, they will be able to learn from and share best practices with other high-performing clinicians, practices, and health systems.

Practices will be provided resources worth thousands of dollars at no cost, except for time and commitment. These include tools such as ACP's Practice Advisor, registries, reporting aids, and online educational resources providing free Maintenance of Certification points and continuing medical education credits. These tools will help develop and maintain the core competencies needed to effect practice transformation.

Last, physicians and practices will benefit from having more engaged and satisfied patients, clinicians, and care teams; improved health outcomes; and a more robust bottom line. And physicians will have peace of mind knowing that they are well prepared to usher in a new era of health care payment and expectations.

A practice is likely eligible to join a PTN as long as it uses a 2014 certified electronic health record and does not participate in another CMS payment reform program, including the Medicare Shared Savings Program, Pioneer ACO, Comprehensive Primary Care initiative, or Multi-payer Advanced Primary Care Practice program.

ACP is a Support and Alignment Network (SAN) grant recipient under TCPI and has committed to helping practices and PTNs find each other. For more information, see the President's Messsage and visit ACP's Practice Resources website or contact ACP directly. Staff will help you connect with the PTN that is right for you.