Transforming Clinical Practice Initiative (TCPi)-Colorado

 

Transforming Clinical Practice Initiative (TCPi) was a national program aimed to support practice transformation efforts towards alternative payment models (APM)s. Launched in 2015, TCPi was the first practice transformation program that supported 140,000 specialists across the country.  HealthTeamWorks Practice Facilitators (PF) and the Clinical Health Information Technology Advisor (CHITA) supported 27 specialty practices, including 8 community mental health centers in Colorado.

The unique support of a CHITA allowed the specialist practices to track and report quality measures as part of their participation in TCPi. Specialty practices are unique in that many require a registry for the practice to focus on quality measures specific to their specialty. Approximately 40% of practices who reported for MIPS used a registry. HealthTeamWorks provided invaluable support for TCPi practices in managing registries and connecting data across registries and EMR.

Additionally, the clinical quality measures (CQMs) that each practice focused on tracking and reporting differed across practices and differs from primary care. For example, it is meaningful for a podiatry practice to track A1c results for patients with diabetes. However, the quality measure of A1c control is not appropriate for the practice to measure their quality of care, since all patients with diabetes have an A1c out of range, hence the clinical necessity to receive podiatry care. HealthTeamWork’s CHITA and PF supported every practice to identify measures to track based on capability and relevance for each practice.

Finally, when TCPi began in 2015, MACRA was signed into law and practices had yet to participate in the Merit-Based Incentive Payment System (MIPS). When coaching began in 2017, many were not prepared to do so for the MIPS 2017 reporting year. All practices that reported MIPS in 2017 and 2018 received a positive payment adjustment. HealthTeamWorks also supported 5 practices in 2017 and 7 practices in 2018 who were exceptional performers, earning more than 70 points and gaining additional financial bonuses. 

 

Year

  Practices reporting for MIPS

Exceptional Performers

2017

19

5

2018

17

7

 

HealthTeamWorks CHITA support allowed specialist practices to thrive in quality performance. Not only are specialists able to provide better quality care for patients, but also be financially rewarded for high performance under MIPS performance. 

More information on the Transforming Clinical Practice Initiative can be found under the following link: https://www.colorado.gov/pacific/healthinnovation/TCPI