Intro: The TransforMN Study's goal is to understand the process by which primary care practices are transformed into health care homes. A key step in that analysis is to test whether change in number of functioning practice systems is correlated with change in quality performance measures.
Methods: Medical leaders from all but one Minnesota clinic certified as health care homes completed a survey that measured the presence and degree of function of 105 clinic systems, both now and as present three years ago. Then we tested the relationship between changes in clinic systems and changes in clinic performance on standardized diabetes and cardiovascular disease outcome measures over the same time period (from MN CM).
Results: 63 clinics had both PPC and adult performance data over the 3 year time period. There was substantial variation in current scores (mean=66.4% of a perfect score with SD=14.0% and range=35.7-94.3%). Mean increase in score over the past 3 years=31.7% with SD=16.7%. Pearson correlation coefficients for the relationship between change in clinic score for systems and change in outcome measures were r=0.42 for diabetes outcomes and 0.52 for cardiovascular disease (p=<.001 and <.0001).
Discussion/Conclusions: Among clinics certified as health care homes, those with the greatest increase in practice systems also demonstrate the greatest improvement in quality. This measure of practice systems may be a valid and important measure of the degree of transformation into medical homes.