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Effects of Hospital Systems on Medical Home Transformation in Primary Care Residency Training Practices

Knierim, Kyle MD; Hall, Tristen MPH; Fernald, Douglas MA; Staff, Thomas J. MD, MPH; Buscaj, Emilie MPH; Allen, Jessica Cornett MD; Onysko, Mary BCPS; Dickinson, W. Perry MD

The Journal of Ambulatory Care Management: July/September 2017 - Volume 40 - Issue 3 - p 220–227
doi: 10.1097/JAC.0000000000000161
Original Articles

Most primary care residency training practices have close financial and administrative relationships with teaching hospitals and health systems. Many residency practices have begun integrating the core principles of the patient-centered medical home (PCMH) into clinical workflows and educational experiences. Little is known about how the relationships with hospitals and health systems affect these transformation efforts. Data from the Colorado Residency PCMH Project were analyzed. Results show that teaching hospitals and health systems have significant opportunities to influence residency practices' transformation, particularly in the areas of supporting team-based care, value-based payment reforms, and health information technology.

Department of Family Medicine, University of Colorado School of Medicine, Aurora (Drs Knierim and Dickinson, Ms Hall, and Mr Fernald); University of Colorado Family Medicine Residency Program, Denver Health Track, University of Colorado School of Medicine, Aurora (Dr Staff); HealthTeamWorks, Golden, Colorado (Ms Buscaj); St. Mary's Family Medicine Residency, Grand Junction, Colorado (Dr Allen); and University of Wyoming School of Pharmacy, Swedish Family Medicine Residency, Littleton, Colorado (Dr Onysko).

Correspondence: Kyle Knierim, MD, 3055 Roslyn St., Ste 100, Denver, CO 80238 (

The authors acknowledge The Colorado Health Foundation for its funding of the Colorado Residency PCMH Collaborative Project.

The authors have no conflicts of interest to report.

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