Safety Net Medical Home Initiative (SNMHI)

In April of 2008, Qualis Health was selected to design and lead the Safety Net Medical Home Initiative in partnership with the MacColl Center for Health Care Innovation at the Group Health Research Institute. The Initiative, funded by The Commonwealth Fund, is a five-year national demonstration project that supports medical home transformation in 65 primary care safety net practices in five states to improve quality, efficiency and patient experience.

What is a Medical Home?

(All measures taken from Patient Centered Medical Home Assessment)

Empanelment measure: Percentage of practices that have achieved Level A or B on Empanelment, indicating that the site has assigned panels, assesses panels for disease management and uses panel data for pre-visit planning, outreach and population management.

Team-based Care measure: Percentage of practices that have achieved Level A or B on Team-Based Care, indicating that the site emphasizes continuity and defines roles and distributes tasks among care team members to reflect the skills, abilities, and credentials of team members.

QI Strategy measure: Percentage of practices that have achieved Level A or B on QI Strategy, indicating that an improvement strategy is being applied to specific problems within the practice; measurement is routine and transparent; and practice teams are supported by a QI infrastructure that involves patients and families.

Care Coordination measure: Percentage of practices that have achieved Level A or B on Care Coordination, indicating that the site has referral protocols in place; takes proactive efforts to follow up with patients seen in the Emergency Department or hospital; and has designated staff available to support proactive coordination between primary care, specialty care and community services.