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Medicare Is Simple
Friday, June 10, 2016
Transforming Clinical Practice Initiative Support and Alignment Networks 2.0
June 10, 2016
By: Patrick Conway, MD, MSc, CMS Acting Principal Deputy Administrator and
Chief Medical Officer
Clinical Practice Initiative Support and Alignment Networks 2.0
Last year, an overwhelmingly bipartisan Congressional majority –
with the support of the medical community and stakeholders – passed the
Medicare Access and CHIP Reauthorization Act of 2015, or MACRA. The law
ended more than a decade of last-minute fixes and 17 potential payment “cliffs”
for thousands of Medicare fee-for-service clinicians, while moving away from
paying for each service a physician provides towards a system that rewards
physicians for coordinating their patient’s care and improving the quality of
Over the past year, we have worked in the same spirit as the
law’s model of partnership and progress as we implement policies to improve the
health and well-being of Americans. Today, the Centers for Medicare &
Medicaid Services (CMS) announces up to $10 million over the next three years
to fund the second round of the Support and Alignment Networks under the Transforming Clinical Practice Initiative
TCPI currently consists of 39 national and regional health care
networks and supporting organizations – Practice Transformation Networks and
Support and Alignment Networks – 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), a key part of the proposed Quality Payment Program.
Eligible Medicare clinicians in the proposed Quality Payment
Program who sufficiently participate in Advanced APMs could receive a 5 percent
bonus Medicare payment beginning in 2019 for their participation in the 2017
performance period. Eligible clinicians who participate in the proposed Quality
Payment Program through the Merit-based Incentive Payment System (MIPS) could
also benefit from participating in APMs. By participating in these models, the
eligible clinicians could receive a favorable scoring standard under MIPS, as
well as extra credit in the Clinical Practice Improvement Activities
performance category. Clinicians who perform well under MIPS in the 2017
performance period may qualify for up to a 4 percent Medicare payment
adjustment in 2019, with additional bonuses for the highest performers.
TCPI helps more clinicians to improve quality, coordinate care,
and spend dollars more wisely by providing peer-to-peer support to primary and
specialty physicians, nurse practitioners, physician assistants, clinical
pharmacists, and their practices. For clinicians that elect to participate in
MIPS, this support will help them be successful. Participating networks also
disseminate best practices and provide technical assistance and coaching to
practices that are moving towards participation in APMs.
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. 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.
CMS encourages all qualified entities to apply for the Support
and Alignment Network 2.0 funding opportunity so that we can continue to build
on the successes we have made so far.