The November issue of features the article Top 10 Transformation Lessons from the Field By Amy Mullins, MD, CPE, FAAFP, who is the Medical Director for Quality Improvement at the American Academy of Family Physicians, based in Leawood, KS.

Rather than condense her article all the way down to a healthsprocket list, we have provided excerpts that provide a little more explanation for each item.

Amy tells us that "the journey through practice transformation can and will be different for everyone, and the process may have a steep learning curve....However, as more and more practices have moved through the stages of transformation, a few major lessons have emerged that can be shared to make the experience for others navigating the process less burdensome.

So here are excerpts from her ten lessons to share:

Lesson One: Practice transformation is a journey that will take time. .....studies have shown the process takes from eighteen months to three years.... A transformation process is a continuous improvement project with very little “destination” at the end. Practices need to sustain the changes they implement, as well as continually find ways to improve.

Lesson Two: Practices need to focus on transformation and not get stuck between transformation and recognition. Transformation is the goal and recognition is the “proof”. The “proof” may be required for possible enhanced payments, but it does not guarantee transformation. Practices need to do what makes the best business sense given their current market environment.

Lesson Three: As healthcare seems to be local, payments for practice transformation work is local. In some areas, practices receive payments in the form of care management fees, some see shared savings, some enhanced fee for service … and some get nothing! But, this is changing…

Lesson Four: Payment reform is here! If it has not occurred already, reform will definitely start to affect your practice in 2019 (based on performance year 2017). In April 2015 the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) was signed into law establishing two tracks for payment that will begin in 2019, the Merit-Based Incentive Payment track (MIPs) and the Alternative Payment Model track (APM).

Lesson Five: You can’t do it alone! Teamwork is essential to transformation, and supportive leadership that models culture change and collaboration reinforces the work done at the practice level.

Lesson Six: A patient’s access to your practice is essential to your ability to improve outcomes and experiences and reduce costs. Providers can raise some of the biggest barriers to access with complicated schedule templates and schedule variation between providers in the same clinic.

Lesson Seven: Technology can be frustrating, but it can save you time.

Lesson Eight: Measures Matter! Measure harmonization is needed across public and private payers to ease the administrative burden surrounding reporting of quality measures.

Lesson Nine: PCMH can work! Demonstration projects, like the Comprehensive Primary Care Initiative (CPC), have shown that PCMH models, or patient-centered function, work.

Lesson Ten: Population health management (PHM) is proactive care! Proactive vs. reactive care for your patients is critical to improve health outcomes and success in receiving value-based payments.