ACP: Center for Practice Innovation - Frequently Asked Questions

Running a Practice

Frequently Asked Questions

What is the “Center for Practice Innovation?”

The Center is a new effort by the American College of Physicians (ACP) to address some of the many needs of small and medium-sized internal medicine practices. The Center will test practice redesign strategies in 25-50 representative physician offices across the United States. The goal will be to improve clinical quality while addressing the impact of such strategies on patient satisfaction, safety, the economics of practice, and the adoption of health information technology.

What are the sources of funding for the new Center?

ACP is one of 26 organizations to receive a grant from the Physicians’ Foundation for Health System Excellence (PFHSE) in 2005. On November 7, 2005, the PFHSE announced the names of the 26 awardees under this first cycle of grant funding from among 400+ applications. The PFHSE is providing ACP a two-year grant of $996,000 to support the development and implementation of the Center for Practice Innovation. The ACP is also committing approximately $125,000 per year through in-kind contributions to the new Center.

What was the origin of the Center for Practice Innovation concept?

The new Center will refine and implement strategies for achieving quality improvements in small and medium-sized practice settings recommended by participants in a February 2005 Quality Summit sponsored by the American Board of Internal Medicine Foundation. This will be accomplished by providing practicing physicians with access to tools, guides, educational workshops and ongoing consultation from experts in small practice economics, health information technology, quality improvement, practice management, physician education, and change management. Interventions will be tailored to the needs of the individual practice and patient population served.

Why target small and medium-sized practices?

Approximately 66% of ACP’s members who provide direct patient care work in practices of 10 or fewer physicians (approximately 46,000 physicians); 50% are in practices of 5 physicians or less. The promulgation of measures and programs that link compensation, public reporting, and technology implementation to achieving better clinical outcomes is coming at a time of economic stress for most small practices. While these programs and legislative agendas are being proposed in the interest of promoting quality and efficiency, there is real concern that without successful models of patient-centered practice redesign and support to achieve the necessary changes in the small practice environment, the unintended consequences of reduced access, persistent quality gaps and lack of innovation will prevail – or even increase.

How will the Center accomplish these objectives?

The Center will:

Develop and disseminate practical quality improvement strategies that are specifically designed for small practices;
Collaborate with other health care quality organizations to rapidly disseminate the Center’s tools, services and programs (e.g., Quality Improvement Organizations, Primary Care Associations, Regional Health Information Organizations, etc.);
Organize and support a pilot program using the Center’s products that includes workshops and consultative support during the pilot modeled after the Institute for Healthcare Improvement’s Breakthrough Series;
Broadly share the results of and lessons learned from the pilot and;
Refine the strategies developed by the Center based on the pilot to create an ongoing and sustainable program for supporting practice innovation in the small practice environment with expansion into larger practices over time.

How will the Center measure its success?

Success will be determined by measuring achievements in improving the quality, safety, and accessibility of excellent primary care using the Institute of Medicine’s six aims for 21st-century health care. Health outcomes will be based on the twenty-six approved Ambulatory Care Quality Alliance (AQA) clinical measures which include metrics for prevention, cancer detection, hypertension, coronary artery disease, congestive heart failure and other significant clinical conditions relevant to internal medicine. Our hypothesis is that the financial concerns of physicians will be addressed through office redesign, attention to quality innovation, enhanced patient satisfaction, and practice growth. The economic impact of the change package implemented in participating practices will be measured. Understanding the return-on-quality (ROQ) is an important element of this proposal since continued investment by physician offices to sustain quality innovation depends on demonstrating the economic benefit of office redesign to enhance quality of care.

Who are the staff and leadership of the new Center?

The Center will draw on support from across the ACP. However, the key leadership and staff of the Center for Practice Innovation include:

Michael S. Barr, MD, MBA, FACP, Vice President, Practice Advocacy and Improvement (20% FTE): Lead and Principal Contact for Grant
Paula Woodward, MPH, RN, CCM, Senior Associate (100% FTE)
William Underwood, MPH, Senior Associate (100% FTE)
Carl Cunningham, MBA, Director Practice Management Center (10% FTE)
Jill A. Marsteller, PhD, MPP, Assistant Professor, Johns Hopkins School of Public Health (10% FTE via contract)

Other ACP staff contributors will include:

Bob Doherty, Senior Vice President, Division of Governmental Affairs and Public Policy
Steven Weinberger, MD, FACP, Senior Vice President, Medical Education and Publishing Division
Brett Baker, Director, Regulatory and Insurer Affairs
Vincenza Snow, MD, FACP, Director Clinical Programs and Quality of Care

A Steering Committee of national experts in practice-based quality improvement will also be identified to guide the Center’s work.