Practice Transformation Initiative (2016 – 2019)

The Practice Transformation Initiative (PTI) was a four-year initiative that engaged 4,800 clinicians statewide contracted with provider organizations to improve measures of cost, quality and patient experience. CQC is one of 41 organizations nationally included in the Centers for Medicare & Medicaid Services’ Transforming Clinical Practice Initiative, which began in 2015. CQC partnered with the Center for Care Innovations (CCI) and the Integrated Healthcare Association (IHA) to execute the program.

The PTI fundamentally changed the approach to providing technical assistance and support at a broad scale in California. The project established key components that are necessary to drive change and also demonstrated that this type of work, though intensive, is more than worth the up-front investment of resources. PTI yielded a total cost savings of $186 million, equivalent to $42,000 saved per PTI enrolled clinician.

The program also yielded the following health outcomes:

• 40,000 patients improved HbA1c control
• 9,700 patients with diabetes improved blood pressure control
• 9,700 patients with hypertension improved blood pressure control
• Reduced unnecessary hospital use
  • 47,000 avoided hospital bed days
  • 17,000 avoided emergency room visits

CQC trained practice facilitation coaches hired by participating organizations — medical groups, independent physician associations (IPAs), community health centers and health plans — to redesign care at 2,000 clinician practices based on the 10 Building Blocks of High-Performing Primary Care. Quarterly meetings with organization leaders fostered peer-to-peer learning to accelerate progress. PTI also offered individualized coaching for each organization, virtual learning sessions, a data results portal and an online community.

Improvement was tracked at the clinician- and provider-organization levels for measures common across Value-Based Payment programs for Medicare, Commercial and Medi-Cal payers.