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This report from the Center for Health Care Strategies, funded by The Commonwealth Fund, describes how independent physician practices can share support networks as they implement quality improvement and practice transformation activities, especially through the Medicaid program. By definition as independent practices, these physicians lack the organizational infrastructure and economies of scale of large medical groups and integrated health delivery networks.   Identifying and sharing clinical and technical services among such independent physician practices would support practice transformation without losing autonomy.  The report explores:

a) essential components of practice supports

b) ways in which Medicaid could purchase, or catalyze providers to invest in, such supports

c) how Medicaid could connect physicians who work in small independent practices

d) financing vehicles, whether already existing in Medicaid or enabled by the Affordable Care Act and

e) key policy recommendations for advancing primary care as fundamental to high-performing health systems.

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