After a fairly quiet year in terms of new funding announcements, the Center for Medicare and Medicaid Innovation (CMMI) has released an $840 million solicitation that seeks to drive 150,000 clinicians toward delivering value-driven care. Billed the Transforming Clinical Practice Initiative or TCPI, the core of the proposal (up to $670 million) seeks to support up to 35 networks of clinician practices that set specific quality improvement and cost reduction goals over a four-year period.
Participating practices can serve Medicare, Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries, casting a very broad net. Primary care and specialty physicians as well as nurse practitioners, physicians assistants and clinical pharmacists are all eligible to participate in PTNs which will likely be constituted by hospitals and health systems, state and regional collaboratives, regional extension centers (focused on advancing adoption of Health Information Technology) and quality improvement organizations.
Awards will range from $2 million to $50 million over a four-year performance period running from May 2015 to April 2019, and funding for years two through four will be contingent upon PTNs achieving performance milestones. PTNs will be expected, among other things, to recruit and retain clinical practices, to drive transformation by providing coaching, technical assistance and other support and to measure and report on practice performances. Emphasis will be placed on PTNs able to recruit practices in areas that are in rural or medically underserved areas or areas with a shortage of healthcare professionals as well as small practices with nine or fewer clinicians.
Supporting the PTNs will be up to 30 entities known as Support and Alignment Networks or SANs. SANs will likely be medical professional societies as well as entities that develop evidence-based clinical practice guidelines or registries and other technologies to support quality improvement. SAN awards will range from $1 million to $3 million over the same four-year performance period.
Optional non-binding letters of intent are due November 20th with completed applications due January 6, 2015. CMMI anticipates announcing awards in early April 2015. At the end of the four years, CMS hopes that at least 75 percent of participants will move on to participate in other value-driven initiatives so the momentum and impact can continue long past the project’s expiration.
It will be interesting to see the level of interest in and response to the solicitation as potential applicants dig in to evaluate and assess their chances.
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