Nurse Practitioner Support and Alignment Network

npsupportandalignmentimageAANP and its partner, the National Nurse-Led Care Consortium (NNCC) are administering a Nurse Practitioner Support and Alignment Network (NP SAN) for the Transforming Clinical Practice Initiative (TCPi), a new program supported by the Center for Medicare and Medicaid Services. The NP SAN will promote nurse practitioner participation in this historic quality improvement initiative.


Almost $700 million was awarded by the Centers for Medicare and Medicaid Services to two types of health care organizations: Practice Transformation Networks (PTNs) and Support & Alignment Networks (SANs). These networks will provide free support to help equip more than 140,000 clinicians with the resources and tools they need to generate better care and better health at lower costs.

The Transforming Clinical Practice Initiative (TCPi) is one of the largest federal investments uniquely designed to support clinicians, including nurse practitioners, with the upcoming changes to the health care system. Whether nurse practitioners are ready or not, these changes are coming.


By 2019, payments to health care providers will be closely tied to quality reporting, resource use, and meaningful use of electronic health records. AANP wants nurse practitioners to be prepared, which is why we partnered with the NNCC to form the Nurse Practitioner Support and Alignment Network (NP SAN) to help nurse practitioners get involved in the TCPi.

The NP SAN works to promote the TCPi, which embraces elements of nurse-led care: patient engagement, team-based care, community engagement, enhanced access, culture of quality, and workforce vitality. Nurse practitioners in either nurse-led or physician-led health care settings are eligible to join.

Our goal is to recruit 7,100 nurse practitioners into the PTNs, which provide clinicians and their practices with individualized technical assistance and one-on-one coaching. The PTNs will assess, educate, and offer peer-supported trainings to enrolled clinicians to help them reduce unnecessary testing, unnecessary hospital admissions, and disparities in health care.

Register Now

Eligibility to Participate in the TCPi

Primary and specialty care physicians, nurse practitioners*, and physician assistants as well as their practices are eligible to participate in the TCPi.

Multi-specialty practices, independent practices, critical access hospitals, rural health clinics, academic medical centers, emergency rooms, federally-qualified health centers, and other types of practices are also eligible to enroll in the TCPi.

Clinicians are NOT eligible to participate in this program if they are already be participating in the following programs:

  • Pioneer Accountable Care Organization (ACO)
  • Medicare Shared Savings Program (MSSP)
  • CMS Comprehensive Primary Care Initiative (CPCI)

For a detailed list of eligible clinicians, please see the 2016 Physician Quality Reporting System List of Eligible Professionals.

The first step to joining this program is to enroll in the NP SAN, by completing this registration form.

Join the NP SAN!

You must fully complete the form to join this program. If you have any questions about the form, please email Chantel DePaepe, AANP Research Associate, at This email address is being protected from spambots. You need JavaScript enabled to view it. .

The information from this form will be reported to the Centers for Medicare and Medicaid Services (CMS), and will be used to refer you to a Practice Transformation Network (PTN). For more information on PTNs, please see "Next Steps" page.

Within a week of completing the registration form, you will receive an email welcoming you to the TCPi. This email will contain additional information on the initiative.


The next step in joining the TCPi is being referred to a Practice Transformation Network (PTN) in your area so that you can receive free training, coaching, and support from a variety of health care professionals. These free resources will help you improve the health outcomes of your patients and increase your revenue.

All you have to do is complete the registration form in the first step of enrollment, and the NP SAN will refer you to a PTN that fits your practice. Each PTN offers a unique set of services and resources to help clinicians transition from fee-for-service to quality and value-based reimbursement. The NP SAN is committed to helping NPs get connected, and participation is free!

PTNs offer nurse practitioners:

  • Online and in-person training
  • Help setting and reaching quality goals
  • Access to expert coaches and mentors
  • “Boots on the ground” technical assistance

After signing a letter of commitment or contract with the PTN, you will be required to:

  • Assign a project champion
  • Share quality and clinical data
  • Participate in PTN meetings and activities
  • Engage in a practice assessment process

What do all the acronyms mean?

  • TCPi: The Transforming Clinical Practice Initiative (TCPi) is a nationwide quality improvement program that was launched by the Centers for Medicare & Medicaid Services (CMS) in 2015. CMS funds support two types of TCPi networks: Support and Alignment Networks (SANs) and Practice Transformation Networks (PTNs). These networks will work together to assist over 140,000 clinicians across the country in practice transformation.
  • SAN: The Support and Alignment Networks recruit clinicians and their affiliated practices into PTNs. They also create and disseminate TCPi-related educational content to PTNs and their enrolled clinicians.
  • PTN: The Practice Transformation Networks offer “boots on the ground” assistance for clinicians to shift from fee-for-service to value-based reimbursements. They help clinicians achieve better care, better health, and lower costs through practice assessments, quality coaching, and access to other tools and resources. Clinicians may join only one PTN.
They help clinicians achieve better care, better health, and lower costs through practice assessments, quality coaching, and access to other resources.

Who is eligible to join the TCPi?

  • Clinicians and practices NOT affiliated with a Pioneer Accountable Care Organization (ACO) or Medicare Shared Savings Program.
  • Primary care nurses practitioners, physicians, and physician assistants.
  • Specialty care nurses practitioners, physicians, and physician assistants. This includes psychologists.

Why should I become involved in the TCPi?

  • Improve the health outcomes of your patients: This initiative will help you implement patient-centered care, reduce unnecessary hospitalizations, and develop care management strategies for high-risk patients.
  • Nurse practitioners (NPs) were consciously chosen as founding partners in the TCPi process: NPs have often been excluded from past payment reform efforts. CMS intentionally included NPs in the design and implementation of the TCPi. This is an opportunity for you to be a part of that design and implementation process.
  • By the end of 2016, 85% of Medicare fee-for-service payments will be tied to quality or value: If you are unable to keep up with the changes to health care payments you could be penalized. Even if you do not join this initiative you will still be affected by the upcoming changes.

What are the benefits of joining the TCPi?

  • Receive customized training, support, and technical assistance at no cost to you or your practice to help you achieve your quality improvement and health care goals.
  • Access to online continuing education sessions to help you succeed in a value-based health care environment.
  • Receive exclusive invitations to webinars about how to enhance team-based care and optimize health information technology.
  • Increase your revenue by learning to prevent value-based payment penalties and how to maximize value-based reimbursements.
  • Reduce costs by modifying clinical workflow and addressing care gaps.

How much will it cost me to join?

IT'S FREE! CMS awarded $685 million to 10 SANs and 29 PTNs. Both networks offer free support and services to eligible clinicians.

How do I enroll?

Go to and complete the register form to enroll.

What happens after I join the NP SAN?

  • You'll receive an invitation to our NP SAN portal page where you can find educational resources and alerts regarding upcoming events.
  • The NP SAN will share your information with an appropriate PTN that will contact you within a week. When the match is made you will be notied by email.
  • The NP SAN may request additional information to determine which PTN is a better fit for you or your practice.
  • You can be referred to a PTN as an individual or as a practice.

How much time and work is required to participate in this initiative?

  • The NP SAN will have a variety of resources and tools that NPs are welcome to utilize with no commitment necessary.
  • Participation in the PTNs will involve:
    • Signing a letter of commitment or contract with the PTN
    • Assigning a project champion
    • Participating in PTN meetings and activities
    • Sharing quality and clinical data
    • Engaging in a practice assessment process
  • Each PTN is a little different but they all try to be as flexible and minimally disruptive as possible. The PTNs are about helping you achieve your own established goals for health care as well as providing better care, more satisfied patients, and lower total medical costs.

Who do I contact for more information?

Lunch n' Learn: Patient Safety in Primary Care Settings by Engaging Patients and Families – Use of "Teach-Back" and "Be Prepared To Be Engaged" Method

Come join us for a FREE one hour Lunch n' Learn event coming up on Wednesday, March 1st at 2:00 pm ET. We welcome our NP SAN members and PTN staff to this invaluable event. This month's Lunch n' Learn will be Part 1 of the 2 Part Series: Patient Safety in Primary Care Settings by Engaging Patients and Families.

  • Part 1: Use of Teach-Back Method & Patient Engagement
  • Part 2: Medication Management & Warm Handoff

On this call will be Kelly Smith, PhD of Medstar Health Research Institute, in collaboration with AHRQ. Kelly will be presenting Part 1 of AHRQs patient safety toolkit and discussing how to deliver the Teach-Back Method to ensure medical information is explained clearly to patients and families for improved understanding and adherence. Additionally, Kelly will be introducing attendees to an exclusive training cohort to implement the entire Patient Safety Toolkit in primary care practices.

Patient safety and engagement have always been primary tenants of nurse-led care. Join us as we explore these themes in greater detail and discuss how they can support your practice ahead of value-based payment reform.

Register Today!


MACRA Quality Payment Program

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), repealed the flawed Sustainable Growth Rate used in Medicare Billing and initiated the transformation of Medicare billing and reimbursement to a value based system. AANP’s team is digging into all 2,398 pages of the Final Rule to assess the impact on our members, patients and the health care system. We’ll be sharing details in the coming weeks.

Additional Quality Payment Program Assistance for Small Practices

The Centers for Medicare & Medicaid Services (CMS) recently awarded $20 million to 11 organizations for the first year of a five-year program to provide on-the-ground training and education about the Quality Payment Program for clinicians in individual or small group practices of 15 clinicians or fewer. Nurse Practitioners and clinicians who have not been successfully referred to a Practice Transformation Network (PTN) after enrolling in the Nurse Practitioner Support and Alignment Network (NP-SAN) can look forward to accessing this new program. Clinicians will receive help choosing and reporting on quality measures, as well as guidance with all aspects of the program, including supporting change management and strategic planning and assessing and optimizing health information technology. As part of that outreach effort, CMS also launched a new telephone helpline for clinicians seeking assistance with the Quality Payment Program. Clinicians may contact the Quality Payment Program by calling 1-866-288-8292 from 8AM – 8PM EST or emailing This email address is being protected from spambots. You need JavaScript enabled to view it. .

Educational Tools

AANP and our partner, the National Nurse-Led Care Consortium (NNCC), have identified and developed educational tools and resources that align with the TCPi Change Package. This educational content serves to support nurse-practitioners and other clinicians in transforming their practices ahead of payment reform.


The American Association of Nurse Practitioners, National Nurse-Led Care Consortium and experts including Dr. Jan Towers, Elizabeth Arend and Dr. Priya Radhakrishnan shared what all nurse practitioners need to know about MACRA during the #TCPiChat. MACRA is the Medicare Access and CHIP Reauthorization Act, which is a complex piece of legislation that creates new billing formulas based on quality. Twitter was used to share crucial information on the transition from fee-for-service to value-based reimbursements with nurse practitioners.

Lunch n’ Learn Series

During this Lunch n' Learn hour, Dr. Gordon Mattimoe, DNP, MSN, NP-C, discusses his research on ways the alignment of the Chronic Care Model (CCM), evidence-based guidelines, and health information technology can be used to design and implement a robust quality improvement program to manage hypertension in rural underserved populations.

Reading the 962-page MACRA rule can be rather daunting, which is why the Transforming Clinical Practice Initiative (TCPi) is here to help nurse practitioners! This Lunch n’ Learn webinar featured Elizabeth Arend, MPH, Quality Improvement Advisor at the National Council for Behavioral Health. She dived into the details of the quality payment program and the expected impact on Psychiatric Nurse Practitioners. Don't get caught unprepared for payment reform!

This webinar featured AANP member Kristine Batty, from the Diabetes Care Solutions, LLC. Dr. Batty is known both locally and nationally as a certified Diabetes Educator. She is dedicated to providing her diabetic patients with the educational, motivational and medical care they need to live long and healthy lives. In this presentation, she discussed how her practice leverages newly available performance incentive payments to capitalize on services her practice has historically provided for free.

Interested in earning CME or MOC credits? Watch the Lunch n’ Learn featuring Dr. Harold Lehmann of Johns Hopkins University and Sunny Ainley of Normandale Community College. Harold and Sunny will introduce 3 online training programs developed by their institutions to support health care staff in their health IT efforts. Each of these programs was developed with all health care team members in mind.

Medication reconciliation can be complex – impacting all patients as they move through different health care settings. During this webinar, Kristine Gleason discussed how her team developed the MATCH toolkit to address one of the most common patient safety errors in health care today. Watch the recorded webinar today to learn how to identify strategies to implement and sustain a successful medication reconciliation process within your practice.

The Role of Nurse Practitioners in the TCPi

Nurse Practitioners have a critical role to play in transforming the way their practices deliver care ahead of coming payment reforms. Learn more about the importance of NP leadership in the changing healthcare environment from Jan Towers, Senior Policy Consultant at AANP, during this virtual open house.

Practice Transformation Networks (PTNs)

Learn how you can join the National Rural Accountable Care Consortium Practice Transformation Network and prepare for payment reform. This network is designed to help small and safety net providers transition from fee-for-service payment models to advanced payment models.

The Consortium for Southeastern Hypertension Control (COSEHC) received a TCPI award to support practice transformation throughout the Southeastern U.S. Practices that enroll in their PTN, QualityImpact, will receive free support and resources to help them transition from fee-for-service to value-based delivery models.

The Care Transitions Network is working synergistically with DSRIP, health homes, and Managed Care to help organizations and their clinicians adopt the changes necessary to succeed in these statewide initiatives, and also stay tuned to their True North – improved quality of care for people with serious mental illness.

Learn how you can transform your clinical practice and prepare for payment reform with the Colorado Practice Transformation Network. The Colorado PTN will provide thousands of clinicians in the state with health IT training, practice coaching, and regional learning collaboratives.


AANP CE Center

  • Online CE Center
  • TCPi-related CE sessions are available under the "TCPI" category on the AANP CE Center.
  • AANP membership may be required to access some CE sessions while other CEs may require creation of a free AANP account.
These sessions incorporate the three primary drivers of the TCPI: patient and family-centered care design, continuous, data-drive quality improvement, and sustainable business operations.

The primary drivers are a part of the TCPi Change Package, which is a practice transformation curriculum that clinicians and their practices can use to achieve better care and better health at lower costs.

External Resources

There are many resources available for NPs to learn more about the TCPi. The following websites include background information, upcoming events, and milestones on this quality improvement initiative.
The Nurse Practitioner Support and Alignment Network is a program of NNCC and supported via a National Cooperative Agreement with CMS.