The Secret Sauce of Health Care Transformation

September 30, 2015   |  Tags: Blog   |  Tags: OHA PCPCH , PCPCH Standards , 3 STAR
Dawn Creach

The Patient-Centered Primary Care Home (PCPCH) Program is off and running with the new 3 STAR designation, intended only for high-functioning, truly transformed patient-centered primary care homes. And now Oregon has its first pediatric 3 STAR practice, Metropolitan Pediatrics’ Northwest in Portland.

Make no mistake, achieving the 3 STAR designation isn’t easy. In my role as their practice coach, I worked with the clinic for months before their site visit, and they invested countless hours preparing. In reality, the infrastructure, processes, and cultural transformation at Metropolitan Pediatrics began many years before their site visit day.

It’s important to keep in mind that the STAR designation currently doesn’t come with any financial rewards or enhanced reimbursement from payers. So why would Metropolitan Pediatrics spend so much time, resources, energy just for a pat on the back and a fancy certificate? 

Some of you may remember my post from November 2014, discussing my hopes for what the (then-proposed) 3 STAR criteria would actually measure at practices - the spirit of innovation, culture of quality improvement, and the pursuit of being truly patient and family-centered.

Well, I believe the STAR designation is largely accomplishing this at a time when change fatigue is setting in and Oregon’s health system transformation seems to be losing steam and direction.

That is what’s so remarkable about Metropolitan Pediatrics’ achievement. As an independent practice, there was no one in a corporate office telling them they had to apply for the STAR designation. Their desire was internally driven by dedicated pediatricians and staff who wanted nothing more than affirmation that their years of hard work have indeed resulted in extraordinary patient care.

I would argue that we should pay more attention to practices like Metropolitan Pediatrics. Excellent patient care happens at the practice level, not at the organization level and certainly not at the health plan level. Without a strong primary care infrastructure, we have no chance of achieving the Triple Aim of improved health, improved patient experience, and controlled costs – not to mention a robust and happy health care work force.  

At a time when policy makers and health plans are focused on moving towards “paying for quality” using narrow quality measures based on out-of-date and often flawed claims data, the PCPCH Program is quietly discovering health care transformation’s secret sauce. Perhaps we can all learn something.

The Team at Metropolitan Pediatrics- Northwest

Dawn Creach, MS is the Program Manager for Medical Home Delivery & Innovation at the Children’s Health Alliance and Children’s Health Foundation. Dawn supports a variety of quality improvement initiatives within CHA, and brings a diverse background in research and evaluation, project management, practice coaching, and significant expertise in the Patient-Centered Medical Home/PCPCH model.

Prior to joining CHA, Dawn worked for the Oregon Health Authority’s PCPCH Program as the lead for technical assistance, site visits, and communications. Previously, she worked at OHSU on various community-based research projects, and directed the evaluation of one of the country’s first national medical home demonstration projects. More recently, Dawn worked with Multnomah County on a strategic plan to integrate behavioral health and primary care, and at the Oregon Pediatric Society as the START (Screening Tools And Referral Training) project manager. Dawn has traveled extensively around Oregon and the country studying innovative medical homes and is passionate about improving healthcare.

Dawn holds a Master of Science in Sociology and a certificate in Project Management from Portland State University, and received her Bachelor of Arts in Sociology from Carroll College in Montana.