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What is the Transforming Clinical Practice Initiative (TCPI)?

In 2015, the Centers for Medicare and Medicaid Services (CMS) TCPI awarded $685 million to 39 national and regional collaborative healthcare transformation networks and supporting organizations. TCPI aimed to:

  • Support more than 140,000 clinicians in their practice transformation work
  • Build the evidence based on practice transformation so that effective solutions can be scaled
  • Improve health outcomes for millions of Medicare, Medicaid and CHIP beneficiaries and other patients
  • Reduce unnecessary hospitalizations for 5 million patients
  • Sustain efficient care delivery by reducing unnecessary testing and procedures
  • Generate $1 to $4 billion in savings to the federal government and commercial payers
  • Transition 75% of practices completing the program to participate in Alternative Payment Models

What is APA's role in TCPI?

APA was a Support and Alignment Network (SAN) that was awarded up to $2.9 million over a four year period to train 3,500 psychiatrists in the clinical and leadership skills needed to support primary care practices that are implementing integrated behavioral health programs. At the end of the grant period in 2019, the APA had trained 3,649 psychiatrists and 380 primary care providers

APA's SAN will train psychiatrists in integrated care in collaboration with the AIMS Center at the University of Washington through online and live trainings. More specifically, the training focused on the Collaborative Care Model (CoCM) and population health principles that will helped prepare psychiatrists for practicing in a value-based world. Once psychiatrists were trained, APA helped connect them with Practice Transformation Networks (PTNs) within the same region for on-the-ground practice transformation support. Through the grant, trainings were developed for primary care providers and behavioral health managers.

How does TCPI fit into APA's Strategic Initiatives?

In 2014, APA commissioned a report to evaluate the potential economic impact of integrated behavioral and medical care for reducing healthcare spending on care for people with chronic medical and behavioral comorbidities. The report found that effective adoption of integrated care can generate significant general healthcare cost savings.

Based on the output of this report, APA announced integrated care as one of its strategic initiatives in 2015. To support this initiative, APA is working to educate its members on integrated care, provide technical assistance in the changing practice environment, and develop and advocate for equitable reimbursement models.

APA's strategic initiative is aligned with TCPI as its overall goals are to improve patient outcomes, decrease costs, and improve coordination of care. Through TCPI, APA is training a workforce of psychiatrists in the Collaborative Care Model (CoCM) who will be ready to work with primary care practices to improve patient outcomes and increase access.

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How does TCPI relate to Payment Reform?

TCPI helped clinicians prepare for payment reform and quality reporting under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). By training in integrated care and participating in TCPI, psychiatrists will be trained with skills required to improve quality and manage population health. In addition, psychiatrists can work with a Practice Transformation Network to receive on-the-ground quality improvement assistance and other support to prepare for MACRA.

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