The Colorado Health Foundation (the Foundation) established a three-and-a-half year funding opportunity, the Team-based Care Initiative (TBCI), to support participating practices in optimizing their existing care teams to deliver high quality, coordinated care. In the planning phase, launched in February 2015, 30 practices received technical assistance to develop work plans and budgets for expanding team-based care (TBC). External coaches provided technical assistance and conducted assessments to support the practices and track progress. In the implementation phase, launched in June 2015, 20 of the 30 practices received funding to implement TBC. Technical assistance providers are delivering support to them through coaching, education, personal consultations, and learning forums.
Mathematica is evaluating participating practices on their progress incorporating the five principles of TBC: shared goals, clear roles, effective communication, mutual trust, and measurable processes and outcomes (Mitchell et al. 2012). These five principles align with the five domains of the TBC success rubric: patient engagement, patient experience, team member experience, practice change, and sustainability. The success rubric and TBC principles informed our evaluation design and research questions, which structure this report.
This is the first of three annual reports that focus on how practice teams plan for and change the ways they deliver care, the barriers and facilitators to change, how technical assistance supports change, and how changes are affecting clinician, staff, and patient satisfaction. This report focuses on practices' initial experiences during the implementation phase of TBCI, including their plans for change. Our analyses rely on data from the baseline survey of clinicians and staff (August 2015), baseline telephone interviews with practice leaders (November and December 2015), baseline and follow-up primary care team guide assessment (PCTGA; May 2015 and February 2016), and the baseline patient survey (May and June 2016). We thank the members of the participating practices, the Technical Assistance Provider team, the practice coaches, and Foundation staff for their contributions to this report.