Written by: Center for Care Innovations

In February 2015, a group of safety net leaders from across the country came together to reimagine what care delivery should look like under a value-based payment model. At this visioning meeting, there was strong agreement that in order to succeed in the future, safety net organizations need to make radical shifts in how they deliver care.

This future vision shows that instead of a care model centered around the clinician-patient relationship, care will be co-created by an expanded care team that includes the patient and community at large. Patients will not only be collaborators, they will also be customers who are able to access care in the locations, times and channels that work best for them. All touchpoints—whether physical, digital or social—will be designed from the customers’ perspective.

In the Reimagined Care Challenge 2016, the Center for Care Innovations (CCI), in partnership with Blue Shield of California Foundation, aimed to build upon the conclusions of that visioning meeting. This program challenged primary care safety net clinics and associated partners to lead the way in creating new approaches to care for the most vulnerable populations in California.

CCI selected ambitious projects based around one or more of three essential strategies: extreme customer orientation, disintermediation, and committed community partnerships. Grantee organizations received up to $80,000 in grants to offset staff time, travel costs for site visits, and other costs associated with implementation of the project. In addition to grant funds, CCI worked closely with grantees to design a focused technical assistance program based upon the needs of the selected organizations.

To wrap up the effort, the Center for Community Health and Evaluation, an independent evaluator, took a look at the projects and solutions developed by grantees.

In the links below, you can explore three case studies.

Health Quality Partners & Engaging Patients in Hypertension Management

Health Quality Partners was interested in designing a home blood pressure monitoring program to engage patients with hypertension in their own care. It saw the project as an opportunity to support community health centers in designing a new program for partnering with patients in blood pressure management. Additionally, it saw the project as an opportunity to test a solution that could be shared and spread to other sites across their member organizations, as they explore value-based care and working with patients outside the health center setting.

West County Health Centers Building on Data Capacity & Community Health

Looking to transform their use of data, West County Health Centers focused on a new approach to community collaboration for population health improvement and transformation toward value-base care by 1) designing an interactive platform that compiles and integrates data from a variety of sources for use with community partners to understand and address the health needs of the population, and 2) taking the data resource into a community setting— “outside the four walls of the health center”— to uncover what data are most important to community stakeholders, can best inform collaboration, and inform future work in the community.

Building a Care Delivery Model at TRUST Health Center

TRUST had only been open for three months when they started the program and their goal was to apply human-centered innovation principles and approaches to creating a new value-based care delivery model that addresses their patients’ medical and nonmedical needs. Since the health center was just launching, there was an opportunity for the program and the approach to influence processes in several areas of clinic operations, including decision making, work flow, and patient experience.



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