The Care Coordination Model

The Care Coordination Model examines care coordination within a patient-centered medical home and considers the major external providers and organizations with which it must interact.

Reducing Care Fragmentation

To help clinical teams lift the quality of patient transitions and referrals, The Commonwealth Fund supported MacColl via Reducing Care Fragmentation to author a complementary set of materials aimed towards patient-centered medical home transformation.

Team Up for Health

The 42-month Team Up for Health initiative, funded by The California HealthCare Foundation, brought patients, their families and clinical teams together to define and test processes leading to better self-management of chronic conditions.

Building Teams in Primary Care

Building Teams in Primary Care, by Tom Bodenheimer, is a report to the California Healthcare Foundation with case studies of 15 diverse practice environments. Dr. Bodenheimer is the Chair of LEAP’s National Advisory Committee.

Coach Medical Home

Coach Medical Home is a web-based curriculum organized into six modules that was developed through the SNMHI initiative.  This curriculum  provides coaches with practical handbooks and presentations for immediate support in their transformation efforts