CMS commits $840M to care transformation

Dept. of Health and Human Services (HHS) Secretary Sylvia M. Burwell announced an $840 million initiative to fund successful applicants who work directly with medical providers to rethink and redesign their practices, moving from systems driven by quantity of care to ones focused on patients’ health outcomes and coordinated healthcare systems.

Applicants could include group practices, healthcare systems, medical provider associations and others in an effort to help clinicians develop strategies to share, adapt and further improve the quality of care they provide, while holding down costs. According to a release, strategies could include:

• Giving doctors better access to patient information, such as information on prescription drug use to help patients take their medications properly;
• Expanding the number of ways patients are able to communicate with the team of clinicians taking care of them;
• Improving the coordination of patient care by primary care providers, specialists and the broader medical community; and
• Using EHRs on a daily basis to examine data on quality and efficiency.

“The administration is partnering with clinicians to find better ways to deliver care, pay providers and distribute information to improve the quality of care we receive and spend our nation’s dollars more wisely,” said Burwell. “We all have a stake in achieving these goals and delivering for patients, providers and taxpayers alike.”

Through the Transforming Clinical Practice Initiative, HHS will invest funds over the next four years to support 150,000 clinicians. With a combination of incentives, tools and information, the initiative will encourage doctors to team with their peers and others to move from volume-driven systems to value-based, patient-centered and coordinated healthcare services. Successful applicants will demonstrate the ability to achieve progress toward measurable goals, such as improving clinical outcomes, reducing unnecessary testing, achieving cost savings and avoiding unnecessary hospitalizations. 

“This model will support and build partnerships with doctors and other clinicians across the country to provide better care to their patients. Clinicians want to spend time with their patients, coordinate care, and improve patient outcomes, and the Centers for Medicare & Medicaid Services wants to be a collaborative partner helping clinicians achieve those goals and spread best practices across the nation,” said Patrick Conway, MD, deputy administrator for innovation and quality and CMS chief medical officer.

Practice Transformation Networks. CMS will award cooperative agreements to group practices, healthcare systems and others that join together to serve as trusted partners in providing clinician practices with quality improvement expertise, best practices, coaching and assistance. These practices have successfully achieved measurable improvements in care by implementing EHRs, coordinating among patients and their families, and performing timely monitoring and interventions of high-risk patients to prevent unnecessary hospitalization and readmissions. Practice Transformation Networks will work with a diverse range of practices, including those in rural communities and those that provide care for the medically underserved.

Support and Alignment Networks. CMS will award cooperative agreements to networks formed by medical professional associations and others who would align their memberships, communication channels, continuing medical education credits and other work to support the Practice Transformation Networks and clinician practices. These Support and Alignment Networks would create an infrastructure to help identify evidence-based practices and policies and disseminate them nationwide, in a scalable, sustainable approach to improved care delivery.

HHS is encouraging all interested clinicians to participate in this initiative.