In partnership with the MacColl Institute for Healthcare Innovation, Qualis Health led the Safety Net Medical Home Initiative (SNMHI), a five year initiative (2008–2013) sponsored by The Commonwealth Fund, and supported by eight regional foundations, to accelerate patient-centered medical home (PCMH) transformation in 65 practices around the country.
The Initiative developed a framework for PCMH transformation, the "Change Concepts for Practice Transformation," and published a library of resources and tools to help practices understand and implement the PCMH Model of Care. As the first national demonstration project to focus on accelerating medical home transformation in the safety net, the SNMHI provided 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. All sites (100%) made significant progress toward implementing the key design features of a PCMH, and nearly half implemented most or all of the 33 PCMH "key changes" to a substantial degree. In addition, 83% of sites achieved NCQA PCMH™ Recognition or a state equivalent.
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 U.S. Department of Veterans Affairs and Indian Health Service sites.
Materials produced by the Initiative include implementation guides, assessment tools, presentations and other materials on the Change Concepts, as well as resources on payment and recognition. All of these items are free and in the public domain, and can be accessed at www.safetynetmedicalhome.org. Additional resources for PCMH coaches and practice facilitators are also available at www.coachmedicalhome.org.
A special supplement to the journal Medical Care, released in November 2014, presents nine papers reporting on the progress made by the participating clinics. These pieces also include baseline and interim observations from an evaluation of the SNMHI conducted by the University of Chicago.