Applying the Value Transformation Framework in Federally Qualified Health Centers to Increase Clinical Measures Performance.

Introduction: The transition in health care from a volume-based to value-based model of care, combined with pressures brought about by the COVID-19 pandemic, makes the need for efficiency and coordination of the health center system imperative. The Value Transformation Framework (VTF), developed with health centers in mind, provides an organizing framework to support transformation of infrastructure, care delivery, and people systems.

Methods: NACHC applied the VTF within a cohort of health centers across the country to drive systems change and improve performance on measures of clinical care.

Results: A comparison of health centers "participating" in application of the VTF relative to "nonparticipating" health centers nationally showed improvement during 3 years of program implementation. Significant differences ( p < .05) favoring health centers who participated were noted for screening of colorectal cancer ( p < .001), depression ( p < .001), hypertension ( p < .001), obesity ( p = .001), and cervical cancer ( p = .011). Performance for diabetes control also favored participating programs, although the difference did not quite reach significance ( p = .45).

Conclusions: Applying a systems approach, organized by the VTF, with evidence-based interventions and deployed in a learning community, can result in improved performance across multiple measures of clinical care.