CMS plans grants to assist physicians with MACRA transition

Agency makes $10 million available to help practices implement the government’s proposed healthcare quality initiative.

The Centers for Medicare and Medicaid Services is taking steps to advance its initiative to revamp the practice of medicine by physicians, announcing today the availability of as much as $10 million over the next three years to fund the second round of support networks for the Transforming Clinical Practice Initiative (TCPI).

The latest round, for Support and Alignment Networks, is intended to assist primary and specialist care in transformation work and learning that “will advance the adoption of alternative payment models on a large scale,” the agency said.

CMS says this new stage of the support networks 2.0 represents a significant enhancement to the TCPI network and will help clinicians prepare for the proposed new Quality Payment Program, which CMS is implementing to replace the Sustainable Growth Rate as an approach for setting physician reimbursement levels.

Information technology is expected to be a critical component of the initiative to revamp care delivered by primary care physicians. CMS describes the initiative, Comprehensive Primary Care Plus, as its biggest effort to transform and improve primary care.

In April, the Department of Health and Human Services issued a proposed rule to align and modernize how Medicare payments are tied to the cost and quality of patient care for hundreds of thousands of doctors and other clinicians. The Notice of Proposed Rulemaking is a first step in implementing certain provisions of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).

The new approach offers a new payment model aimed at incentivizng doctors to produce better health outcomes. CMS says the goal is to improve healthcare quality and cost while enabling physicians and patients to have more control over care delivery.

Key to the transformation will be the ability of physicians and consumers to take advantage of IT to unlock healthcare data and move to value-based payment models, supported by improved communication and the use of technology to coordinate care. IT will be a crucial enabler of expansions of service, such as serving patients' healthcare needs outside of the physician office and sharing patient information to better coordinate care among care team members.

CMS says technical assistance, outreach and other support provided to clinicians by TCPI Practice Transformation Networks and Support and Alignment Networks advances the implementation of the proposed Quality Payment Program and the overall goals of moving away from paying for each service a clinician provides, toward a system that rewards clinicians for coordinating their patients’ care and improving the quality of care delivered.

The TCPI 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, the Support and Alignment Network 2.0 awardees will identify, enroll and provide tailored technical assistance to advanced clinician practices in an effort to reduce Medicare, Medicaid and Children’s Health Insurance Program (CHIP) program expenditures by supporting practices through the phases of transformation and enhancing the quality, efficiency and coordination of care they deliver.

TCPI currently consists of 39 national and regional health care networks and supporting organizations that provide assistance to thousands of clinicians in all 50 states to improve care coordination and quality and to better understand their patients’ needs. These networks are a key support for clinicians preparing for the payment changes under MACRA by helping clinicians transform the way they deliver care and participate in Alternative Payment Models (APMs), CMS says,

“Today’s announcement continues to support clinicians across the country in transforming their practices by requiring competitive applications to have signed commitments to enroll a minimum 5,000 or more eligible clinicians and their practices in their network,” noted Patrick Conway, MD, acting principal deputy administrator and chief medical officer at CMS. “These clinician practices must be advanced in delivering high-quality and efficient care, so that they can quickly learn from the initiative, support improvement at scale, and join APMs.

“As a practicing physician, I know the importance of quality improvement support and sharing of best practices to help clinicians transform their practice and deliver outstanding care to every patient,” Conway added.

CMS will award cooperative agreement funding to successful applicants that may include health care delivery systems and health care delivery plans that: 1) presently provide quality improvement support to a large number of clinicians; 2) are multi-regional or national in scope; 3) are involved in generating evidence-based guidelines for clinical practice; 4) are effectively using measurement through clinical registries and electronic health records; and 5) are committed to expanding action to improve safety and person and family engagement. Medical professional associations and specialty societies may also apply.

Competitive applications will have received signed commitments to enroll 5,000 or more eligible clinicians and their practices that are in advanced states of readiness to deliver high quality care at lower costs (e.g., transformation Phases 4 and 5) in their network.

Applications will be accepted from eligible applicants for the cooperative agreement funding opportunity starting June 10, 2016. Applicants are encouraged, but not required, to submit a letter of intent by July 1, 2016. Letters of intent may be submitted to Applications are due to CMS no later than 3 p.m ET on July 11 and must be submitted via

More for you

Loading data for hdm_tax_topic #better-outcomes...