From the President and CEO: Safety Nets' Journey to Becoming Medical Homes

Message from the President and CEO

April 22, 2014

Seven years ago, the REACH Foundation convened a group of health leaders, clinic directors, hospital executives and foundation leaders to examine the medical home model as an approach to expanding the capacity of the region’s safety net health care system and achieving improved health outcomes for patients. Nearly 80 people gathered with us over two days for presentations and discussions about whether Kansas City’s safety net health care clinics were ready to take on this model. There was quite a bit of skepticism among clinic directors and staff, but when the REACH Foundation launched its Medical Home Initiative late in 2007, there were four clinics that signed on to take the journey with us.

Last month, Qualis Health, a nonprofit health care consulting firm, published “The Journey Towards the Patient-Centered Medical Home: The Kansas City ¬†Experience,” a white paper that describes the journey of nine safety net primary care clinics as they worked with a technical assistance team from Qualis to implement core principles and practices of a patient-centered medical home. The white paper describes the technical assistance and practice transformation with the clinics.

We believe this white paper tells an important story about a diverse group of safety net clinics that committed to re-examining their service delivery approaches to become more patient-focused. Their transformation efforts required leadership commitment, reorganization into health care teams, introduction of electronic medical records in clinics that were dependent on paper records, commitment to data collection and monitoring, rethinking of staff roles and responsibilities (and a lot of training to support new roles), and more.

Like any large-scale systems change effort, the transformation to a medical home model didn’t move in a smooth, linear fashion. There were slowdowns and setbacks along the way. However, each of the clinics made substantial improvements in access to care, coordination of care, and patient communication and patient experience.

What are some of the lessons learned? The white paper touches on several key considerations:

  • Engaged senior leadership is critical to success.
  • Safety net clinics can adopt empanelment and become “continuity clinics.”
  • Information systems can impede transformation depending on their functionality and ability to adapt to meet the clinic’s needs.
  • Transformation requires time and teamwork, and cannot be rushed.
  • Being patient-centered is a continuous process and requires ongoing growth and commitment.

To date, the REACH Foundation has invested more than $1.5 million in the initiative, including supplemental grants to support Electronic Medical Records implementation and other technology, care management staff positions, training of medical interpreters and more.

Read the full text of the President and CEO Message: Download PDF

Read the white paper: Download PDF