The new program, called the Transforming Clinical Practice Initiative, was conceived to complement federal efforts already underway that establish new incentives for quality and efficiency, and bolster the use of information technology to increase clinicians' and patients' timely access to medical records and other crucial data, Conway said. “This is part of a larger strategy for health system transformation,” he said.
Networks will fall into two categories: Practice Transformation Networks, which will pair providers who have had prior success with quality improvement and cost containment with those who need help; and Support and Alignment Networks, which will include associations and other organizations with the ability to broadly communicate and educate providers.
Practice Transformation Networks will receive the bulk of the CMS funding, up to $670 million, and the Innovation Center estimates it will award 35 grants ranging from $2 million to $50 million. That funding can be used for health information technology, but health IT cannot account for more than 10% of the total award. The Support and Alignment Network program will distribute another $30 million to as many as 30 networks. The amounts are expected to range from $1 million to $3 million. Applicants for the Support and Alignment Networks will include medical and specialty associations, and patient safety and quality improvement organizations.
The Innovation Center, which was created by the Patient and Protection and Affordable Care Act and received $10 billion in funding from the law, will largely fund the awards.
The initiative is one of the latest announced by the Innovation Center that seeks to build capacity among providers without the experience or financing to invest in health delivery changes or the ability to bear the risk of new incentives to do so. The center said earlier this month that the program would target small and rural providers, offering them capital loans to become accountable care organizations. Officials are seeking Practice Transformation Network applications that have at least one-fifth of their participating clinicians practicing in small groups or rural or medically underserved communities.
The infusion of funding follows new Medicare programs created under the healthcare reform law that pay providers under accountable care contracts and other experimental payment models, such as bundles. Early progress has been uneven and publicly available information on results has been limited and delayed. The first Medicare ACOs, which launched in January 2012, saw quality and financial performance results for their peers for the first time this month.
Many stand to gain from the new initiative, but it's not likely that all of the participants will be able to capitalize on the networks. For organizations that have already sought education from others or shared their experiences, the federally funded networks could help to subsidize those efforts, said Dr. Kavita Patel, managing director for clinical transformation for the Brookings Institution. And, for independent physician groups that hope to avoid a merger with a better-capitalized hospital, newly funded networks may supply the needed expertise and investment to stay solo and revamp their practices, she said.
But the funding may be out of reach for organizations that have done little planning ahead of the announcement because of a tight application deadline, Patel said. Applications are due Jan. 6.
The award criteria underscore areas that federal officials have targeted for improvement, such as proposals to reduce unnecessary testing by specialists and reporting of core performance measures identified by each network. Multiple networks' measures will be expected to converge eventually, the Innovation Center said.
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