TransforMED's Strategic Role in Healthcare Reform
When the American Academy of Family Physicians made the bold decision in 2004 to commit significant funds from reserves to launch an initiative now called TransforMED, no one had any idea where it would lead. The Future of Family Medicine report stated that if Family Medicine did not change and the healthcare system did not change, there was a good chance that Family Medicine (and indeed primary care) might cease to exist. The good news is that the US Healthcare system is changing and Family Medicine and primary care are starting to change.
TransforMED launched at exactly the right time to be positioned to develop the tools and resources to support practice transformation, but more importantly to be the national leader for transformation at the payer, system and practice levels. TransforMED was also the leader in payer pilots in the early days of PCMH as well as the "go to" resource for health systems and physician groups. More recently TransforMED has become the recognized leader in the Medicaid environment. The editor of one major publication even referred to TransforMED as the "gold standard."
The advocacy efforts of the primary care associations and the PCPCC coupled with the rapidly escalating needs of the US healthcare system have led to dramatic initiatives at the federal level. There was the HITECH act clearly defining deliverables and objectives for healthcare technology followed by the Healthcare Reform Bill (Affordable Care Act) that has redefined how healthcare is delivered in this country. Primary Care is now part of the solution and not part of the problem. There is strong recognition that care must be managed and coordinated, the patient must be engaged and the rapid evolutions in healthcare technology are here to stay.
Two tangible results of this significant transformation are the CMS/CMMI Comprehensive Primary Care Initiative (CPCI) and the CMS/ CMMI Medical Neighborhood Innovation. The CPCI redefines the deliverables for primary care while clearly laying out new payment methodologies for primary care in a multi-payer environment. TransforMED was chosen as the "national convener"/supporter of this very important initiative. TransforMED was also awarded a $22M grant to build "medical neighborhoods" in 16 health system markets around the country demonstrating how care should be coordinated and managed between primary care, specialists and hospital systems with primary care practices the hub of the medical neighborhood. The Comprehensive Primary Care Initiative involves providers, patients and payers while the Medical Neighborhood Innovation involves providers, patients and health systems. Both initiatives have a strong focus on engaging and coordinating with the specialists involved in a patient's care. TransforMED is involved at multiple levels in the major transformations in healthcare going on in this country. Not only CMS/CMMI, but the Army and the State of Ohio have engaged TransforMED for major high-profile initiatives. TransforMED continues to work with insurers, employers and health systems to complete the sweep. TransforMED is recognized as a national leader in hospitals systems wanting to build Accountable Care Organizations.
TransforMED's mission statement is "the transformation of healthcare delivery to achieve optimal patient care, professional satisfaction and success of primary care practices." "Transformation of healthcare delivery" in this country seemed like a stretch to many back in 2006 when the mission statement was established, but the TransforMED Board even in 2006 appreciated the potential of TransforMED.