1. Transforming Clinical Practice Compass PTN Learning Community
The State of the Union
Tom Evans, MD
Compass PTN Learning Community
Winter 2019 1

2. Objectives
Discuss the Transforming Clinical Practice Initiative (TCPi) and next steps for clinicians and practices
Recognize how these collaborative programs will affect quality improvement and facilitate whole-system transformation
Describe Exemplar status and opportunities for the future
We are not a GPO, HRE, health analytics or dues-driven membership organization.
We do not endorse vendors of any type.
HEN 1.0 and HEN 2.0
SIM with IME
IDPH
National Committees
DC/policy maker relationships

3. Delivery System Reform
Three-part Aim
Delivery System Reform
Healthier People
Better Care
Smarter Spending
The Triple Aim
National
State
Community

4. Delivery System Reform

5. Health Care and GDP

8. Delivery System Reform Requires Focus Distribute Information
Pay Providers
Deliver Care
Distribute Information

9. MACRA: QPP Quality Payment Program4
Alternative Payment Models (APM) 3 2 1
Merit-based Incentive Payment System (MIPS)
Note: This is not a test. This is law.

10. MIPS Payment Adjustment Schedule

11. Transforming Clinical Practice Initiative (TCPI)

13. MACRA: QPP Quality Payment Program4
Alternative Payment Models (APM) 3 2 1
Merit-based Incentive Payment System (MIPS)

15. Delivery System Reform Requires Focus
Provider
Payment
Help!!
Care Delivery
Information
Distribution

16. TCPI: 5 Phases of Transformation
Compass understands each clinic may be at a different point and need to work on different PDSAs to achieve the ultimate goal.
Source: CMS TCPI PTN Information Webinar, November 20, 2014.

17. PTNs Determine Exemplars
Not Yet Exemplary
PTN Enrolled Practices
Phase 2, 3
Exemplary
Phase 4, 5

18. PTNs Determine Exemplars
Not Yet Exemplary
PTN Formal Process To Assess, Verify Exemplars
Enrolled Practices
Phase 2, 3
Exemplary
Phase 4, 5

19. PTNs Determine Exemplars
Not Yet Exemplary
PTN Formal Process To Assess, Verify Exemplars
Enrolled Practices
Phase 2, 3
Exemplary
Phase 4, 5
PTN National Exemplary Practice Registry

20. PTN Formal Process To Assess, Verify Exemplars
PTNs Market Exemplars
Not Yet Exemplary
PTN Formal Process To Assess, Verify Exemplars
Enrolled Practices
Phase 2, 3
Exemplary
Phase 4, 5
PTN National Exemplary Practice Registry
Payers (ACOs)

21. Compass PTN Definition of Exemplar Practices
Phase Progression: Phase IV or V (or III)
Provide a “Story Worth Emulating”
Practice can demonstrate (articulate and display) on at least 2 of the 4 TCPi Service Delivery Aims
(Outcomes, Utilization, Hospitalization, Tests and Procedures)
Patient and Family Engagement (PFE)
Reporting on at least 3 of the 6 PFE measures
We are not a GPO, HRE, health analytics or dues-driven membership organization.
We do not endorse vendors of any type.
HEN 1.0 and HEN 2.0
SIM with IME
IDPH
National Committees
DC/policy maker relationships

22. A Story Worth Emulating
Patient-centered Goal
What was the envisioned purpose of change
Intervention
What did you do to change care
Data
What measures? How did you use to inform process?
Results
What happened?
Patient-centered Impact
How was care improved from the patient’s perspective?
We are not a GPO, HRE, health analytics or dues-driven membership organization.
We do not endorse vendors of any type.
HEN 1.0 and HEN 2.0
SIM with IME
IDPH
National Committees
DC/policy maker relationships

23. On the Horizon

25. Implementing Quality Improvement Priorities Across Key Settings of Care
Priority Focus Areas
Clinicians in Clinical Practices
Hospitals (acute care, specialty, LTACs, IRFs)
Nursing Homes
Community Coalitions
Opioids & Behavioral Health
Burden Reduction (includes QI reporting)
Patient Safety
Chronic Disease Self-Management
Care Transitions
Nursing Home Quality
Rural Health, Vulnerable Populations and Patient & Family Engagement are Cross-cutting Priorities

26. “On the Horizon” Take Home Points
It’s really going to happen. It can’t not happen.
From “more is better” to “better is more”
You can run, but you can’t hide. Data is the currency of improvement.
Run hard on this last lap…maximize the resources available
Become an Exemplar
We are not a GPO, HRE, health analytics or dues-driven membership organization.
We do not endorse vendors of any type.
HEN 1.0 and HEN 2.0
SIM with IME
IDPH
National Committees
DC/policy maker relationships