Projects
The MacColl Center for Health Care Innovation's recent work has included developing regional collaborations between health care systems, local governments, and purchasers in improving the delivery of care, as well as a continued focus on fostering the implementation of innovative strategies in integrated health systems. Recent MacColl projects show the range of work in:
- Regional improvement
- The patient-centered medical home
- Innovation at Group Health
- Care coordination
- Cancer care strategies
Regional improvement
The Institute of Medicine's 2001 report, Crossing the Quality Chasm, calls for a coordinated effort to align measurement, incentives, and concerted improvement to fix American's broken health care system. Coalitions are a promising structure for effecting this change, and the MacColl Center offers a new model, The Framework for Creating a Regional Health Care System, an introductory look at public and private stakeholders currently working together to improve health care in many regions of the country.
Aligning Forces for Quality (AF4Q) is an ambitious effort by the Robert Wood Johnson Foundation (RWJF) in 17 targeted communities. AF4Q aims to increase the overall quality of health care, reduce racial and ethnic disparities, and provide models for national reform. In total, the AF4Q regions encompass almost 38 million people, or one in eight Americans, and one in seven primary care physicians in the United States. Begun in 2006, the program intends to drive local change that is expected to show measurable improvements by 2015. The program’s design draws on the regional framework developed by the MacColl Center. MacColl staff are leading technical assistance efforts within ambulatory-care quality improvement initiatives in the sites.
Technical assistance for Prescription for Pennsylvania: “Rx for PA” is Governor Rendell's comprehensive health care reform initiative to address the access, affordability, and quality of that state’s health care. It’s a set of integrated strategies to eliminate inefficiencies in the health care system, better manage chronic conditions, eliminate health facility-acquired infections, implement common-sense insurance reforms, and offer the uninsured access to affordable health care insurance. Embedded into Rx for PA is the Chronic Care Model. Since Rx for PA was rolled out in January 2007, The Henry J. Kaiser Family Foundation, The Robert Wood Johnson Foundation, and Families USA have recognized it for its reasonable approach to health care reform.
The patient-centered medical home
In 2008, supported by The Commonwealth Fund and in partnership with Qualis Health, the MacColl Center embarked on a major demonstration project, The Safety Net Medical Home Initiative, helping more than 50 safety net practices in five regions become high-functioning patient-centered medical home (PCMH) sites. The PCMH concept promotes delivering patient-centered care to achieve better health outcomes through care coordination and improved access and payment. This is urgently needed by not only providers and systems engaged in efforts to improve the quality of primary care, but purchasers and policy makers searching for a vehicle for payment reform. A key feature of the PCMH is providing patients with more access to their personal care physicians and clinical teams.
Innovation at Group Health
In the spring of 2007, the MacColl Center summarized Group Health's plans around innovation, and proposed a role for Group Health Research Institute (GHRI) in this work through the newly formed Partnership for Innovation, comprising leaders from the Group Health care-delivery system and the Group Health Foundation. Since 2009, MacColl has been active in project development and oversight of the review process for the Foundation’s ongoing Partnership for Innovation grants program.
Care coordination
In 2009, the MacColl Center, supported by the Commonwealth Fund, began a project to develop a toolkit that patient-centered medical homes can use to implement care-coordination activities. During the course of the two-year project, the MacColl team will review relevant literature, conduct interviews with care-coordination experts from medicine, nursing, and social work, and identify best practices for referral. At completion, the project team will develop a toolkit to help primary care practices achieve high performance for this critical area of care. The toolkit will include the evidence to support care coordination, key concept changes, resources to implement each key concept, and case studies of best practices. MacColl’s primary website will house the “Achieving Best Practice for Patient Referral” toolkit.
Cancer care strategies
The MacColl Center has an ongoing commitment to studying the organizational factors related to delivering cancer care in health systems. MacColl Director Ed Wagner, MD, MPH, has served as the principal investigator of the HMO Cancer Research Network (CRN) since its inception. CRN consists of the research programs, enrolled populations, and data systems of 14 health maintenance organizations nationwide.
The overall goal of the CRN, and of the National Cancer Institute initiative under which it was funded, is to use this consortium of delivery systems to conduct research on cancer prevention, early detection, treatment, long-term care, and surveillance.