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Unlocking the Black Box: Supporting Practices to Become Patient-Centered Medical Homes

doctor patient hospital health care


The five-year Safety Net Medical Home Initiative was launched with Commonwealth Fund support in 2008 to help 65 safety-net clinics in five states become patient-centered medical homes. The project team developed a technical assistance framework to assist practices in adopting the medical home model.

What the Study Found

The components of the technical assistance framework included: 
  • individual site-level coaching by medical home facilitators, which most sites received monthly (61%) or at least quarterly (22%);
  • the creation of a learning community to help health centers interact with each other to share best practices and brainstorm;
  • data monitoring and feedback on selected measures of clinical quality, transformation, patient experience, provider and staff satisfaction, and utilization;
  • resources and materials, including guides, tools, and webinars; and
  • small grants to fund special projects like staff training videos or patient education materials.


In a survey, practices indicated that peer-learning opportunities, including in-person meetings and field trips, were particularly helpful. However, gathering, reporting, and using clinical data for quality improvement remain challenges for many practices.

Publication Details



Jonathan Sugarman, Former President and CEO, Qualis Health

[email protected]


K. Coleman, K. E. Phillips, N. Van Borkulo et al., "Unlocking the Black Box: Supporting Practices to Become Patient-Centered Medical Homes," Medical Care, Nov. 2014 52(11 Suppl. 4):S11–S17.