ACA-Transforming Clinical Practice Initiative: Support and Alignment Networks (SANs)
The Transforming Clinical Practice Initiative (TCPI) model will test whether a three-pronged approach to national technical assistance will enable large scale transformation of thousands of clinician practices to deliver better care and result in better health outcomes at lower costs. ? Support Alignment Networks (SANs) formed by group practices, health care systems, and others that join together to serve as trusted partners to provide clinician practices with quality improvement (QI) expertise, best practices, coaching and help as they prepare and begin clinical and operational practice transformation. These organizations will collaboratively lead clinicians and practices through the TCPI phases of transformation, achieve the TCPI goals, and through adaptive redesign position these clinicians and their practices to be sustainable components of the changing care delivery system.
General information about this opportunity
Last Known Status
Centers For Medicare and Medicaid Services, Department of Health and Human Services
Type(s) of Assistance Offered
B - Project Grants
Section 1115A of the Social Security Act (the Act), as added by § 3021 of the Affordable Care Act, which authorizes the Center for Medicare & Medicaid Innovation (CMMI or the Innovation Center) to test innovative payment and service delivery models to reduce spending under Medicare, Medicaid, or CHIP, while preserving or enhancing the quality of care furnished to beneficiaries under those programs. The TCPI is a service delivery model that tests whether providing technical assistance in a specific complex adaptive manner will enable clinicians and their practices to rapidly transform the way they deliver care to patients, resulting in improved health outcomes and reduced costs. The authority for the TCPI model is section 1115A of the Social Security Act (the Act). Under section 1115A(d)(1) of the Act, the Secretary of Health and Human Services may waive such requirements of Titles XI and XVIII and of sections 1902(a)(1), 1902(a)(13), and 1903(m)(2)(A)(iii) as may be necessary solely for purposes of carrying out section 1115A with respect to testing models described in section 1115A(b). For this model and consistent with this standard, the Secretary may consider issuing waivers of certain fraud and abuse provisions in sections 1128A, 1128B, and 1877 of the Act. Waivers are not being issued in this document; waivers, if any, would be set forth in separately issued documentation. Thus, notwithstanding any other provision of this Funding Opportunity Announcement, awardees and subawardees must comply with all applicable laws and regulations, except as explicitly provided in any such separately documented waiver issued pursuant to section 1115A(d)(1) specifically for the TCPI model. Any such waiver would apply solely to the TCPI model and could differ in scope or design from waivers granted for other programs or models.
Who is eligible to apply/benefit from this assistance?
CMS anticipates that SANs will include but not be limited to organizations like: o Public Nonprofit Institution/Organization o Specialized group o Profit Organization o Private Nonprofit Institution/Organization o Quasi-public Nonprofit Institution/Organization o Other private institution/organization *Clinicians receiving other CMMI support (e.g. CPCI) and those already participating in alternate payment programs (e.g. Medicare Shared Savings Program) are not eligible for participation in TCPI.
The Beneficiary eligibility includes the list as noted above with the exception of: o Federal, Interstate o Intrastate o Student/Trainee and Graduate Students o Artist/Humanist o Engineer/Architect, Builder/Contractor/Developer o Farmer/Rancher/Agriculture Producer o Industrialist/Business Person o Small Business Person o Homeowner o Property Owner o Anyone/General Public
What is the process for applying and being award this assistance?
Preapplication coordination is required. N/A
This program is excluded from coverage under 2 CFR 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards.
Successful applicants will receive a Notice of Award (NoA) signed and dated by the CMS Grants Management Officer that will set forth the amount of the award and other pertinent information. The award will also include standard Terms and Conditions, and may also include additional specific cooperative agreement terms and conditions. Potential applicants should be aware that special requirements could apply to cooperative agreement awards based on the particular circumstances of the effort to be supported and/or deficiencies identified in the application by the review panel. The NoA is the legal document issued to notify the awardee that an award has been made and that funds may be requested from the HHS payment system. The NoA will be sent electronically to the awardee organization as listed on its SF 424. Any communication between CMS and awardees prior to issuance of the NoA is not an authorization to begin performance of a project. Unsuccessful applicants will be notified by letter, sent through electronically to the applicant organization as listed on its SF 424.
October 23, 2014 to January 6, 2015 The application for this FOA is due on grants.gov by January 6, 2015. Applicants are highly encouraged to submit a Letter of Intent by November 20, 2014.
Approval/Disapproval Decision Time
The anticipated date of awards for Transforming Clinical Practice Initiative is April 2015.
How are proposals selected?
See Section V of the FOA.
How may assistance be used?
The funds shall be used to implement, manage toward results, and evaluate models that support system transformation toward higher quality care at lower costs. Award dollars cannot be used for specific components, devices, equipment, or personnel that are not integrated into the entire service delivery model proposal. Funds shall not be used to build or purchase health information technology or other information technology that exceed more than 10% of total costs of the applicant’s proposed budget. CMS will not fund proposals that replicate models that CMS is currently testing in other initiatives.
What are the requirements after being awarded this opportunity?
CMS will enlist a third party entity to assist CMS in monitoring the model implementation and testing performance results and outcomes. CMS plans to collect data elements to be part of monitoring for all of the different networks, and these monitoring and surveillance elements will feed into the evaluation. All awardees will be required to cooperate in providing the necessary data elements to CMS or a CMS contractor. The contractor would assist CMS in developing a cost, quality, and population health monitoring and review network performance to ensure requirements are met; tracking performance across awardees and providing for rapid cycle evaluation and early detection of performance problems; developing a system to collect, store, and analyze data to assess health care cost and utilization, quality performance, and population health improvements and assisting with awardee implementation, including coordination between awardees and CMS and its other contractors.
TCPI participants are required to keep records for a minimum of 30 days after the conclusion of the TCPI program.
Other Assistance Considerations
Formula and Matching Requirements
Statutory formula is not applicable to this assistance listing.
Matching requirements are not applicable to this assistance listing.
This program has MOE requirements, see funding agency for further details. Additional Information:
Length and Time Phasing of Assistance
N/A Method of awarding/releasing assistance: Quarterly.
Who do I contact about this opportunity?
Regional or Local Office
Grants Management Officer Centers for Medicare & Medicaid Services Office of Acquisitions and Grants Management Phone: 410-786-5239
Fred Butler, Jr.
7500 Security Boulevard
Baltimore, MD 21244 US
(Cooperative Agreements) FY 18$7,104,814.00; FY 19 est $0.00; FY 20 est $0.00; FY 17$7,162,654.00; FY 16$8,702,926.00; -
Range and Average of Financial Assistance
This will be a new service delivery model. Therefore, no funds ($0) have been requested for past or current fiscal years.
Regulations, Guidelines and Literature
Examples of Funded Projects