Quality Changes Among Primary Care Clinicians Participating in the Transforming Clinical Practice Initiative

The Transforming Clinical Practice Initiative (TCPI) was designed to provide technical assistance to clinicians and prepare practices to participate in value-based payment arrangements. In this longitudinal cohort study, we assessed whether clinician's participation in TCPI practice transformation networks (PTNs) was associated with changes in quality of care from 2016 to 2018. We extracted quarterly measure performance data from 2016 to 2018 on two NQF-endorsed measures, one for outcome (Controlling High Blood Pressure) and one for process (Use of Imaging Studies for Low Back Pain), from 1,981 primary care clinicians enrolled in the PRIME Registry. Clinicians participating in PTNs were identified and compared with their counterparts who did not participate in PTNs. We found that the performance of PTN clinicians on controlling high blood pressure and use of imaging studies for low back pain was equivalent to that of non-PTN clinicians during the first 3 years of the TCPI. Although PTNs provided assistance to help practices achieve their clinical outcomes, these findings suggest that the changes in quality of care, for the measures studied, among PTN clinicians in the first 3 years of the TCPI were attributable to temporal trends rather than participation in PTNs.