As this article is being published, Dr. Holly is in Washington, D.C., attending the Centers for Medicare and Medicaid Services (CMS) Quality Conference and the introductory faculty meeting for the Transforming Clinical Practice Initiative (TCPI).  The TCPI will involve 140,000 practices, 5,000,000 patients and 40 faculty members.

The initiative is designed to support clinician practices over the next four years in sharing, adapting and further developing their comprehensive quality improvement strategies. The initiative is one part of a strategy advanced by the Affordable Care Act to strengthen the quality of patient care and spend health care dollars more wisely. It aligns with the criteria for innovative models set forth in the Affordable Care Act:

• Promoting broad payment and practice reform in primary care and specialty care,
• Promoting care coordination between providers of services and suppliers,
• Establishing community-based health teams to support chronic care management, and
• Promoting improved quality and reduced cost by developing a collaborative of institutions that support practice transformation

SETMA’s Involvement with Lewin and CMS’ TCPI
(See:  http://jameslhollymd.com/Letters/cmss-transforming-clinical-practice-initiative)

The Lewin Group was engaged by CMS to provide support for TCPI, which is designed to help clinicians achieve large-scale health transformation.   On September 30, 2015, Christy Guillory, M.S., J.D., Senior Consultant for The Lewin Group, contacted SETMA’s Director of Operations, Mrs. Margaret Ross, and asked to set up a conference call with Dr. Holly, SETMA’s CEO.   SETMA was identified because of the work we do in transformation.  <s Guillory asked for brief 30 minute call before end of business day Friday (October 2nd).

A call was scheduled for 1 PM CDT on October 1, 2015.  That thirty minute call turned into one hour.  Before the call, Dr. Holly sent extensive information to Ms. Guillory.  (to review that material see the link above)  The conference call was very engaging professionally and personally.  Ms. Guillory is from Louisiana, as is Dr. Holly.  We briefly shared our common background but really found a shared vision for health care transformation.  After the call, Ms. Guillory sent me a copy of the Wall Street Journal article announcing the CMS’s Transforming Clinical Practice Initiative.  That article is reproduced in part here:

U.S. to Give Almost $700 Million in Grants to Improve Patient Care
Wall Street Journal // Stephanie Armour // September 29, 2015

“Dozens of doctors’ offices, hospitals and other health groups will get almost $700 million to improve patient care as part of the Obama administration’s initiative to overhaul payment models for medical providers.

“The grants... reflect the administration’s focus on rewarding providers for how well they treat patients, and not how many they see. It also illustrates a shift away from implementing the health law to transforming patient care.

“Nearly 40 national and regional health-care networks and supporting organizations are being awarded $685 million in grants, part of an initiative that marks one of the largest federal investments to increase collaboration between doctors and other clinicians. The funding will be used for a variety of ambulatory-care programs, from continuing education to training on the use of patient data to improve care.

“’These awards will give patients more of the information they need to make informed decisions about their care and give clinicians access to information and support to improve care coordination and quality outcomes,’ Ms. Burwell said in a news release.

“’As we start focusing on the effectiveness of care, this is an idea whose time has come,’ said Dr. Tom Evans, president and chief executive officer of the Iowa Healthcare Collaborative, a provider-led nonprofit that focuses on driving clinical improvements. ‘This will be an expansion of our work to another dimension.’

“Proponents of the initiatives say they will help reduce U.S. health-care costs at a time when growth in national health spending, which had dropped to historic lows in recent years, is on the upswing. American spending on all health care grew 5.5% in 2014 from the previous year and will grow 5.3% this year, according to actuaries at CM S.’”

HHS Announces $840 Million Initiative To Improve Patient Care and Lower Costs. 

This TCPI effort is especially significant to the behavioral health community. With implementation of the Affordable Care Act and the Mental Health Parity and Addiction Equity Act, more than 60 million Americans will gain access to new or expanded coverage for mental health and substance abuse services. As our health system broadens, the behavioral health field has a responsibility to lead in setting comprehensive goals to develop the workforce, improve quality, and provide effective services to individuals with behavioral health conditions.

The Practice Transformation Networks are peer-based learning networks designed to coach, mentor, and assist clinicians in developing core competencies specific to practice transformation. This approach allows clinician practices to become actively engaged in the transformation. It also ensures collaboration among a broad community of practices that create, promote, and sustain learning and improvement across the health care system.

The Support and Alignment Network will provide a system for workforce development using national and regional professional associations and public-private partnerships that are currently working in practice transformation efforts. Utilizing existing and emerging tools (e.g., continuing medical education, maintenance of certification, core competency development), this network will help ensure sustainability of these efforts. These tools will especially support the recruitment of clinician practices serving small, rural, and medically underserved communities and play an active role in the alignment of new learning.

Dr. Holly Invited to serve on the 40 Member Faculty for the TCPI Program

On October 28, 2015, Ms. Guillory contacted Dr. Holly about his serving on the faculty for the TCPI Program.  On November 4th, she notified Dr. Holly that he was accepted for the faculty. 

The following description of the Faculty is from CMS:  TCPI will convene TCPI National Faculty, as part of the team, which will be critical to the success of the TCPI.  The faculty will be clinicians and non-clinicians who have had an impact on and proven results related to their organization’s transformative practices.  They are from high performing practices with various professional backgrounds and expertise, including executive leadership, operations, financials, clinical care, quality improvement and other areas that contributed to high performance.

The faculty will share their knowledge of and expertise in best practices, interventions and evidence-based approaches that work. The faculty will participate in development of the change package for TCPI and in deploying best practices and change package content. They will also facilitate learning around the barriers that need to be overcome when transforming a clinical practice. They will provide support for the PTN and SAN action learning events.  In essence, they will serve as TCPI champions in the field. 

Each faculty member has a powerful performance and transformation story to share.  We will work with the faculty to create a powerful leadership story around their performance experience. The faculty will learn how to give presentations that trigger commitment to action in others and help others to develop their own leadership stories.