Developing effective partnerships to support practice transformation and population health strategies.
Year two of the Coordinating All Resources Effectively (CARE) Award, a CMMI-funded project to transform care and payment models for children with complex medical conditions, is underway. Participating organizations have uncovered lessons for engaging primary care practices in this effort. Whether primary care physician (PCP) practices are aligned with the children's hospital or operate independently, organizations must fortify clinical relationships to support effective practice transformation and population health strategies. Here are some ways organizations can achieve this:
Gain support. Create a common understanding of issues and what the groups hope to accomplish together. Incorporate perspectives of PCP practice participants early and often in the process. Review progress and evolve shared goals over time.
Make time for transformation. Unless organizations build in specific paid time for quality improvement activities, clinicians may be reluctant to partner or participate.
Begin contractual agreements early. Depending on the existing legal relationship with collaborating PCP practices and the need for funded time, the entities could require a contractual agreement to partner. This process could take upwards of 3 to 6 months depending on the legal climate.
Leverage leadership. Leadership comes in the form of the CEO who makes transformation a priority and assigns a champion to foster frequent communication among team members within the system. Leadership also comes from identifying and empowering clinical leaders, even at small independent practices with few employees, who will carry forward the shared vision for transformation. Leaders are essential from above and within to set the tone for change.
Access untapped assets. PCPs may offer strengths and resources that will benefit transformation and create more buy-in. Expertise that participants found in CARE Award physician partners included prior quality improvement experience, medical home transformation or certification work, and family engagement. Expertise and knowledge from clinical partners shapes and improves the design of care transformation—it's also a huge benefit to share with others inside and outside of the immediate effort.
As part of the CARE Award, care coordinators, medical social workers and practice transformation facilitators were identified as integral resources for care transformation, especially for building capacity to complete key functions of these roles within existing staff in the PCP practice. Participants anticipate that these resources will be sustainably funded through the new payment models in development.
This publication was made possible by Grant Number 1C1CMS331335 from the Department of Health and Human Services, Centers for Medicare & Medicaid Services. The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies.