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Innovative Care Delivery   ICD    Practice Transformation

What is Practice Transformation?

Practice transformation (transformation) is a process involving continuous evaluation and evolution of organizational tools and processes with a goal to advance quality improvement and patient-centered care (See 1 and 2 in Related Articles). Transformation helps practices adapt to an evolving reimbursement environment focused on value (See 3 in Related Articles).

Care Transformation Organizations

Care Transformation Organizations (CTOs) are recognized by the Centers for Medicare & Medicaid Services (CMS) under the Maryland Primary Care Program (MDPCP) to assist practices with transformation efforts. CTOs provide an array of advanced care delivery support services to practices, including care coordination, care transitions, standardized beneficiary screening, and data tools and informatics. Approximately 25 CTOs participate in the MDPCP. More information about the MDPCP is available here. 

Demonstration Project: Advancing Practice Transformation in Ambulatory Practices

In June 2021, MHCC competitively awarded MedChi Care Transformation Organization (MedChi CTO) a grant to engage up to 50 Maryland-based ambulatory practices (practices) to complete select practice transformation milestones (milestones). The milestones include assessing practice readiness for transformation, redesigning workflows, and guiding practices through the completion of the Transforming Clinical Practice Initiative (TCPI) Seven Support Change Package Modules (modules). Implementation of the TCPI modules provide practices with techniques that help improve patient health outcomes.  

Approximately 32 practices completed milestones in Round 1, which ended June 2023. An additional 12 practices began Round 2 of the program in January 2023. The program is currently accepting applications, available here.

Information about the TCPI modules is available here.

Questions about the grant can be sent to mhcc.grants@maryland.gov.

Related Articles

  1. Abraham, M. R., & McGann, P. (2019).  Contribution of the Transforming Clinical Practice Initiative in Advancing the Movement to Value-Based Care.  Annals of Family Medicine. Available at:  ncbi.nlm.nih.gov/pmc/articles/PMC6827664/ 
  2. The University of New Mexico, Practice Transformation.  Available at: hsc.unm.edu/scaetc/programs-services/pt.html 
  3. Robinson, C., Lee, J. W., Davis, K. N., & O'Connor, M. (2019).  Findings From FMAHealth's Bright Spots in Practice Transformation Project.  Family Medicine.  Available at: pubmed.ncbi.nlm.nih.gov/30736038/ 
  4. American College of Physicians, Alternative Payment Models. Available at: acponline.org/practice-resources/business-resources/payment/medicare-payment-and-regulations-resources/macra-and-the-quality-payment-program/alternative-payment-models-apms 
  5. Phillips, R. L., Jr, Cohen, D. J., Kaufman, A., Dickinson, W. P., & Cykert, S. (2019).  Facilitating Practice Transformation in Frontline Health Care.  Annals of Family Medicine.  Available at: ncbi.nlm.nih.gov/pmc/articles/PMC6827672/. 
  6. Smith, P. C., Lyon, C., English, A. F., & Conry, C. (2019). Practice Transformation Under the University of Colorado's Primary Care Redesign Model.  Annals of Family Medicine.  Available at:  ncbi.nlm.nih.gov/pmc/articles/PMC6827666/. 
  7. Qureshi, N., Quigley, D. D., & Hays, R. D. (2020). Nationwide Qualitative Study of Practice Leader Perspectives on What It Takes to Transform into a Patient-Centered Medical Home. Journal of General Internal Medicine.  Available at:  escholarship.org/uc/item/39f6x2r0. 

Additional Resources

Overview Presentation – Advancing Practice Transformation in Ambulatory Practices 

Background on MHCC grant opportunity, program objectives, and transformation milestones   

TCPI Change Package

Outlines tangible steps to guide transformation efforts and meet TCPI training milestone goals 

Support and Alignment Network Power Packs

Illustrates specific pathways to resolve challenges that practices may encounter in the process of transforming 

Transforming Clinical Practice Initiative - Results from Maryland Practices in the Garden Practice Transformation Network

Highlights transformation progress of Maryland practices that participated in the Garden Practice Transformation Network 


Last Updated: 1/31/2024