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Great Lakes Practice Transformation Network Letter of Participation
This Letter of Participation is between the aforementioned Participant Institution and the Service Delivery Institution of Illinois (Northwestern University), Indiana (Purdue Healthcare Advisors) or Michigan (Altarum Institute), part of the Great Lakes Practice Transformation Network. The purpose of this Letter of Participation is to show commitment between the Participant Institution and Service Delivery Institution in Transforming Clinical Practices Initiative (TCPI) work, which aims to transform the practices of 11,500 clinicians across Indiana, Illinois, and Michigan, into learning practices capable of providing better health and improved care at a lower cost.
By entering into this Letter of Participation, Participant Institution is acknowledging that they are not a member of: a) Medicare Accountable Care Organization (Pioneer ACO program); b) Shared Savings Program; c) Multi-payer advanced primary care program; or d) Comprehensive primary care initiative. This
does not exclude the participant from joining one of these alternate payment model programs in future years. Participant Institution also acknowledges they can only have membership in one CMS funded practice transformation network.
Each organization participating in the Great Lakes Practice Transformation Network will be offered technical assistance and support consisting of National, Regional and State-based tools and resources. Local, State-based resources consist of Quality Improvement Advisors (“QIA’s) who will coach the Participant through the Transforming Clinical Practice Initiative’s (TCPI) five phases of patient-centric practice transformation. QIAs can provide direct technical assistance to help prepare clinicians for participation in value-based payment systems: a) Meaningful Use; b) Physician Quality Reporting System/Value Based Payment Modifier; c) Patient-Centered Medical Home; and d) MIPS.
Participants will have the opportunity to participate in focused improvement efforts chosen from, but not limited to the following menu:
Medication Management (HBP Control)
Medication Management (Anticoagulants)
Depression Screening & Follow-up
Other, Practice identified priorities for clinical quality improvement
In support of the Participants, Quality Improvement Advisors will utilize the GLPTN “Transformational Change Toolkit” that integrates multiple practice transformation approaches:
Implementation science: Developing tools, processes, and strategies for rapid, efficient, and sustainable implementation of evidence-based programs and practices in the local “real world.”
Lean and Six Sigma process improvement tools
Patient-centric, personalized population health management
Practice assessment and monthly feedback loop
Participant will also have access to National CMS Transforming Clinical Practice Initiative (TCPI) Resources:
TCPI Knowledge Management website with access to registration for CMS events, improvement curriculum, tools and resource management
Support & Alignment Network (SAN) to achieve alignment with medical education, maintenance of certification.
TCPI National Faculty Expertsto provide expertise to continuing development and spread of TCPI Aims and Goals
National Community of Practicewhere content and resources are available for all member participants
Participant agrees to actively collaborate with Service Delivery Institution to implement these Services. In order to do this, the Participant commits to the following:
Dedicate timely resources to the project
Designate a point of contact and /internal QI champion
Regularly communicate with the QIA
Participate in the completion of an initial readiness assessment and continuous measurement and assessment of practice advancement through the phases of transformation
Actively participate in transformational activities
Participation in the Physician Quality Reporting System, if eligible.
Participation in the Value Modifier Program.
Data Sharing: aggregate data on chosen quality improvement measures will be collected and reported to CMS quarterly, as well as, utilized by the network to produce monthly feedback reports for participating practices
The term of this participation coincides with the period of the Practice Transformation Network award received from CMS. The award expires 9/28/2019. This Agreement will expire six (6) months after completion of the completion of the TCPI five phases ofpatient-centric practice transformation or no later than the award expiration date. If the participant joins an Accountable Care Organization,Shared Saving Program, multi-payer advanced primary care program, comprehensive primary care initiative or other practice transformation network Service Delivery Institution must be notified and this notification will constitute as the termination of this Letter of Participation. Demographic information will be requested (see Attachment A). This agreement shall expire if demographic information is not submitted within 30 days.
Number of sites being enrolled in PTN
Total number of clinicians being enrolled in PTN
Type of Organization
Assisted Living Facility
Organ Procurement Organization
HRSA Offices and Bureaus
Quality Improvement Organization - QIO
State Based Improvement Organization
Federally Qualified Health Center - FQHC
Private Single Specialty Practice
Private Multi Specialty Practice
Hospital/Health System Owned
Academic Institution Affiliate
Does your patient population include Medicare, Medicaid or CHIP? (Yes or No)
Site point of contact (provider, practice manager, medical assistant, etc.)
By checking this box, I agree to become a participant in the Great Lakes Practice Transformation Network and will comply with all terms and conditions of the participation agreement.
Please complete the following demographic data collection spreadsheet within 30 days to finalize participation in the Great Lakes Practice Transformation Network.
Participant Demographic Information (Excel File)