Transforming Safety Net Clinics into Patient-Centered Medical Homes Evaluation Project

Pharmacy in Safety Net Health CenterIn May 2008, The Commonwealth Fund launched a five-year initiative to transform 65 safety-net clinics in Colorado, Idaho, Massachusetts, Oregon, and Pennsylvania into patient-centered medical homes (PCMHs).  Qualis Health and the MacColl Institute for Healthcare Innovation support the clinics’ efforts to become medical homes. Dr. Marshall Chin and co-investigators based at the University of Chicago lead a multi-method evaluation of the initiative that incorporates surveys of clinic leaders, providers, staff, and patients; analysis of clinical and administrative data; and qualitative interviews.  The evaluation focuses on three major questions:

1)  Do the safety net clinics participating in this initiative become patient-centered medical homes?

2) Are the participating safety net clinics providing:

a) Better clinical quality
b) Better staff experience
c) Better patient experience
d) More efficient care

3) What seemed to be associated with a clinic’s successful implementation or adoption of the medical home concept?

The evaluation of the Safety Net Medical Home Initiative aims to make important practical contributions towards elucidating and measuring the PCMH, and answering key questions on attainment of the PCMH, outcomes, efficiency, and implementation.

Marshall Chin presenting

Principal Investigator: Marshall H. Chin, MD, MPH

Co-Investigators:

Deborah L. Burnet, MD, MA, Co-Investigator, is a dually trained general internist and pediatrician who conducts community-based research on obesity and type 2 diabetes risk in children.  Dr. Burnet supports the evaluation with her specific knowledge of pediatrics in ambulatory care settings.

Lawrence Casalino, MD, PhD, Co-Investigator, Livingston Farrand Associate Professor at Cornell Weill College of Medicine, is a national authority on leadership, organizational change and management.  He supports the evaluation with his specific knowledge of quantitative and qualitative methodologies for studying and affecting organizational change.

Elbert S. Huang, MD, MPH, Co-Investigator, is a general internist with expertise in decision analytic modeling, meta-analysis, and cost-effectiveness analysis.  He has performed one of the few empirical studies in the literature on the business case for quality improvement, concentrating on diabetes quality improvement in community health centers with the Health Disparities Collaboratives. Dr. Huang leads the business case analysis and contributes to the Medicaid efficiency analyses.

Robert Nocon, MHS, Senior Health Services Researcher, co-manages the SNMHI evaluation. His research focuses on cost and organization of care in safety net settings.  He leads a cost analysis of the medical home using Medicaid claims data.

Michael T. Quinn, PhD, Co-Investigator, is a social psychologist who is expert in qualitative and quantitative evaluation techniques. He has extensive experience conducting and analyzing one-on-one interviews and focus groups, and evaluating programs.  He leads the interviews of safety net clinic staff regarding what factors facilitate or impede successful implementation of the PCMH.

Thomas Summerfelt, PhD, Co-Investigator, Director of Research in Advocate Health Systems, is expert in working with large administrative datasets to investigate community health interventions and issues related to systems of care. He assists with the Medicaid efficiency analyses.

Project Staff:

Paige Fairchild, MPH, Project Coordinator, organizes the survey administration for the SNMHI evaluation. She coordinates evaluations of organizational changes in participating clinics, as well as changes in provider, staff, and patient experience in participating clinics.

Yue Gao, MPH, Programmer/Statistician, provides data management and analysis support for the SNMHI evaluation.  She executes all statistical analysis and also provides feedback for the study’s methods and analytic plans.

Kathryn Gunter, MPH, MSW, Project Manager, co-manages the SNMHI evaluation.  She coordinates the study of clinical quality in participating clinics and assists with a project on care coordination in the rural safety net.

Sang Mee Lee, PhD, Statistician, Research Associate (Assistant Professor) in the Department of Health Studies, has primary responsibility for developing the statistical methodology for all analyses.  She provides consultation on quantitative methods and analyses for all aspects of the evaluation.

Funding Source:
The Commonwealth Fund

Additional Resources:
The Safety Net Medical Home Scale
Scoring Algorithm for The Safety Net Medical Home Scale
Provider Experience Survey
Scoring Algorithm for Provider Experience Survey
Staff Experience Survey
Scoring Algorithm for Staff Experience Survey