Safety Net Medical Home Initiative

Since May 2008, the MacColl Center has been working with Qualis Health and The Commonwealth Fund on a five-year demonstration project. The project is helping 65 primary care safety net sites to become high-performing patient-centered medical homes and to achieve benchmark levels of quality, efficiency, and patient experience. In collaboration with a national advisory panel, MacColl developed eight change concepts that encapsulate the changes required for a practice to transform into a patient-centered medical home. Other similar medical home efforts, including the APCP demonstration described above, have adopted these concepts.

The Safety Net Medical Home Initiative received applications for participation from 42 organizations in 31 states. Five Regional Coordinating Centers were selected, and each worked in partnership with 10 to 15 primary care safety net sites in their respective states: Colorado, Idaho, Massachusetts, Oregon, and Pennsylvania. In a “train-the-trainer” model, the Initiative provided these regions with support for practice coaches, technical assistance, resources, and tools.

The MacColl Center’s work for the Initiative has included developing:

Developed with sponsorship from The Commonwealth Fund and in close partnership with Qualis Health and the National Association of Community Health Centers, the curriculum will be launched in 2013.


Primary Care Teams: Learning from Effective Ambulatory Practices (LEAP)

How can U.S. primary care practices best adapt their workforce to a rapidly changing health care environment? The MacColl Center aims to find answers as the leader of a national program called Primary Care Teams: Learning from Effective Ambulatory Practices (LEAP). The project began its first phase in March 2012 with a $3.3 million grant from the Robert Wood Johnson Foundation.

LEAP is identifying and visiting 30 high-functioning primary care practices nationwide to study workforce model innovations that can be replicated and adopted widely. Experts nominated more than 400 practices to take part in the program, which is funded through June 2014.

LEAP will study practices in various locations and settings, including small private practices, large health systems, and community health centers. The researchers will focus on training programs, policy changes, and staff arrangements that have improved outcomes for practices and patients. Later, LEAP will help the sites form a learning community to share best practices and distill their innovations into a toolkit that others can use.

MacColl Center Director Emeritus Ed Wagner, MD, MPH, co-directs the LEAP program with Margaret Flinter, PhD, APRN, senior vice president and clinical director of the Community Health Center, Inc., a federally qualified health center in Connecticut. Thomas S. Bodenheimer, MD, MPH, an adjunct professor at the University of California, San Francisco, School of Medicine, chairs the project’s national advisory committee, which has developed the criteria for selecting the primary-care practices that the program will study.

The MacColl Center serves as the project’s national program office.


Regional Improvement Projects

The MacColl Center has provided technical assistance for several regional improvement efforts, including:

In addition, the MacColl Center’s Framework for Creating a Regional Healthcare System provides an introductory look at how public and private stakeholders can work together to improve health care at a regional level.


Transforming Primary Care: Evaluating the Spread of Group Health’s Medical Home

Following a positive evaluation of Group Health’s patient‑centered medical home model of primary care in 2010, Group Health leadership decided to spread the model to all 26 of its medical centers. With funds from the Agency for Healthcare Research and Quality, the MacColl Center is studying this widespread implementation, evaluating its impact on cost, utilization, and quality of care. Robert J. Reid, MD, PhD, Group Health’s associate medical director for research translation, is leading the evaluation.


Group Health’s Partnership for Innovation

The Partnership for Innovation is a Group Health Foundation donor-funded grants program that gives Group Health staff members an opportunity to pilot-test cost-effective improvements to patient care. The MacColl Center staff provides technical assistance to the program, which has funded more than 25 projects with over $2 million since it began in 2008.


Improving Chronic Illness Care website

As the national program office for the Robert Wood Johnson Foundation’s Improving Chronic Illness Care (ICIC) initiative from 1998 until 2011, the MacColl Center has developed a robust online library of resources. The Center continues to support and develop this popular ICIC website, which includes literature reviews, learning guides, and toolkits on topics such as the Chronic Care Model, care coordination, practice change, the patient-centered medical home, and regional quality improvement.