Primary Care Transformation Grants

AHRQ recognizes that revitalizing the Nation’s primary care system is foundational to achieving high-quality, accessible, and efficient health care for all Americans. The patient-centered medical home (PCMH) (also referred to as the primary care medical home, advanced primary care, or the health care home) is a promising model for transforming the organization and delivery of primary care.

AHRQ has invested more than $12 million and funded three grant initiatives to better understand the challenges faced by primary care practices as they transform into PCMHs and to help create an infrastructure to assist them with this transformation. Information about these three grant initiatives and materials that synthesize the valuable insights and knowledge gained from these grants are provided below.

Transforming Primary Care Practice (TPC) grants were funded to understand the "natural experiments" that primary care practices undergo as they transform into PCMHs and to study the process of transformation. The following materials have been developed to share the results and lessons learned from this initiative with the field:

• A journal supplement in the Annals of Family Medicine that includes an article about each project, an overview paper discussing lessons learned across the 14 grants, and a joint article about the importance of context in primary care transformation efforts.
• The AHRQ Transforming Primary Care Grants Bibliography, which includes citations for and short summaries of the more than 50 peer-reviewed articles resulting from this grant initiative so far. The evidence generated from this initiative has formed a solid foundation to understand and assist with future primary care improvement.
• A summary report (PDF FIle, 827 KB) synthesizing the findings and lessons learned across the 14 grants.

Infrastructure for Maintaining Primary Care Transformation (IMPaCT) grants were funded to State-level initiatives that had demonstrated success in providing a quality improvement infrastructure for primary care, specifically through the use of primary care extension agents. Each of the four “model States” developed collaborations with three or four “partner States” to share the successful infrastructure they had developed. In total, 17 States worked together to build a support system to assist primary care practices with their transformation efforts. The following materials have been developed to describe these efforts:

• A summary report (PDF FIle; 820 KB) synthesizing findings across the IMPaCT grants.
• An interactive Catalog of Tools and Resources that includes materials developed by IMPaCT grantees and partner States to support and train others in primary care transformation and quality improvement.

More information on the work of the IMPaCT grants can be found at http://healthextensiontoolkit.org https://www.statereforum.org/IMPaCTing-Improvements-in-Primary-Care.

Estimating the Costs of Supporting Primary Care Practice Transformation grants were funded to provide stakeholders with information about the costs of implementing and sustaining transformative primary care practice redesign. Stakeholders include independent primary care practices, health care systems, health care payers, and other health care system decision makers. Grantees estimated the costs of primary care transformation using a variety of methods drawn from the fields of accounting, management, and econometrics. Projects estimated direct costs, such as staff time and equipment, and indirect costs, such as overhead and forgone revenue. Many studies also estimated the costs of attaining and maintaining PCMH recognition.

• The Practical Guide to Measuring the Costs of Primary Care Transformation (PDF File, 1.4 MB), which summarizes the methods used by grantees to measure the direct and indirect costs of transforming primary care and the advantages and disadvantages of each method.