Medical Care special issue features Safety Net Medical Home Initiative

Progress report on landmark initiative to improve care for vulnerable populations

Seattle–A special November supplement to the journal Medical Care presents the progress and lessons learned from the Safety Net Medical Home Initiative (SNMHI), the largest and most rigorous initiative to spread this model of care to safety net practices that treat people who are uninsured, underserved, or both. Group Health was a pioneer in implementing and evaluating the patient-centered medical home. A team from the MacColl Center for Health Care Innovation at Group Health Research Institute (GHRI) co-led the initiative with Qualis Health, funded by The Commonwealth Fund.

The supplemental issue presents nine papers describing the 2008–2013 multi-state initiative that tested a replicable, sustainable implementation model to transform primary care safety net practices into patient-centered medical homes with benchmark performance in quality, efficiency, and patient experience. The issue features manuscripts contributed by Edward Wagner, MD, MPH; Katie Coleman, MSPH; Karin Johnson, PhD; Judith Schaefer, MPH; Brian Austin, and Jessica Ridpath of GHRI—and their colleagues at Qualis Health, The University of Chicago, and The Commonwealth Fund.

“For anyone seeking to transform the American health care system, the SNMHI experience provides important lessons to demonstrate how practice redesign can be achieved,” said Qualis Health President and CEO Jonathan Sugarman, MD, MPH, principal investigator for the SNMHI. “This initiative shows that successful implementation relies on a planned, sequenced approach, with an early focus on ensuring engaged leadership and a robust quality improvement strategy.”

In an effort to improve patient care, retain high-quality primary care providers, and control costs, practices across the United States are transforming to patient-centered medical homes. As the first national demonstration project to focus on accelerating medical home transformation in the safety net, the SNMHI provides important insights into the challenges and opportunities associated with redesigning primary care among practices serving the most vulnerable, underserved populations. The project was implemented at 65 safety net practices in Colorado, Idaho, Massachusetts, Oregon, and Pennsylvania.

The supplement is now available online at http://journals.lww.com/lww-medicalcare/toc/2014/11001. The issue reports on the progress the participating clinics made, and it includes baseline and interim observations from an evaluation of the SNMHI conducted by the University of Chicago, whose outcome findings are expected in 2015–2016. The supplemental issue was made possible with funding from The Commonwealth Fund. Rated as one of the top-10 journals in health care administration, Medical Care is the official journal of the Medical Care Section of the American Public Health Association.

Safety Net Medical Home Initiative

The Safety Net Medical Home Initiative (SNMHI) was led by Qualis Health and the MacColl Center for Health Care Innovation at Group Health Research Institute, supported by The Commonwealth Fund. The SNMHI was grounded in the efforts of five regional coordinating centers and 65 safety net practice sites, and generated a freely available library of resources proven to effectively guide the transformation of primary care practices into patient-centered medical homes. The SNMHI developed, tested and refined an evidence-based framework for PCMH transformation—The Change Concepts for Practice Transformation —supported by a comprehensive library of resources and tools to help practices understand and implement the patient-centered medical home model of care. After extensive testing, the model and its resources have now been used effectively by primary care practices of all types including community health centers, private practices, academic medical centers, critical access hospitals, and VA and Indian Health Service sites. All resources are free, in the public domain, and available at www.SafetyNetMedicalHome.org.

Qualis Health

Qualis Health is one of the nation’s leading population health management organizations, and a leader in improving care delivery and patient outcomes, working with clients throughout the public and private sector to advance the quality, efficiency and value of health care for millions of Americans every day. We deliver solutions to ensure that our partners transform the care they provide, with a focus on process improvement, care management and effective use of health information technology. 

The Commonwealth Fund

The mission of The Commonwealth Fund is to promote a high-performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society's most vulnerable, including low-income people, the uninsured, minority Americans, young children, and elderly adults. The Fund carries out this mandate by supporting independent research on health care issues and making grants to improve health care practice and policy. 

MacColl Center for Health Care Innovation at Group Health Research Institute

Named for a Group Health founder and pioneering physician, the MacColl Center for Health Care Innovation at Group Health Research Institute (GHRI) was established in 1992 and is led by Michael Parchman, MD, MPH. In the mid-1990s the Center developed the Chronic Care Model, a widely endorsed and adopted approach to improving ambulatory care that has guided clinical quality initiatives in the United States and internationally. For more than 20 years MacColl has supported the transformation of health care delivery through innovative research, model development, training and technical assistance.

About Kaiser Permanente

Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, Kaiser Permanente has a mission to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve more than 12.4 million members in eight states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal Permanente Medical Group physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: kp.org/share.