CMS launches $840M transformation initiative

The federal government is offering new funding to help healthcare providers that are less far along in the care transformation process catch up.

Last week, the CMS Innovation Center announced it will spend $840 million over four years to help doctors and hospitals do more to teach each other how to improve quality and cut wasteful practices. The four-year effort, called the Transforming Clinical Practices Initiative, is expected to include 150,000 clinicians working in networks where they will swap ideas, trade information and learn from others’ mistakes and successes. The investment is a bet that sharing care-improvement experiences among medical groups, health systems and others will push the industry more rapidly toward more efficient models of care.

Dr. Patrick Conway, director of the innovation center, said the effort is projected to save $1 billion to $5 billion over four years and could prevent 5 million avoidable hospitalizations. Networks of providers, associations, agencies and others will draw on and disseminate successful strategies to deliver less costly, more effective care and enable others to learn from those successes. “We will take good ideas and best practices from anywhere we can find them,” he said.

The new program was conceived to complement ongoing federal efforts 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 data. “This is part of a larger strategy for health system transformation,” Conway 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. The innovation center estimates it will award 35 grants ranging from $2 million to $50 million. 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. Another $100 million will finance implementation, and quality improvement organizations will receive the remaining $40 million to improve recruitment and assessment.