Primary Care Transformation

Transforming primary care to better serve patients has been at the heart of our work since Dr. Ed Wagner and his team developed the widely adopted Chronic Care Model in the mid-1990s.

Primary Care Transformation

Transforming care to better serve patients is at the heart of what we do.

Transforming care with a practical, patient-centered approach since the 1990s

Transforming primary care to better serve patients has been at the heart of our work since Dr. Ed Wagner and team developed the widely adopted Chronic Care Model in the mid-1990s. The Chronic Care Model reshaped how care teams and patients worldwide navigate chronic illness care. With a patient-centered, evidence-based approach focused on population health, the Chronic Care Model became the new standard in caring for chronic conditions — and the inspiration for our future work.

Since then our team has leveraged this foundational experience to develop dozens of practical tools to support care transformation. 

  • In partnership with generous funders, patients, and health systems large and small, we specialize in co-designing and testing new, patient-centered models of care based on research evidence and best practices. 

  • We support their implementation in practice by designing approaches including ‘at-the-elbow’ practice facilitation, collaboratives, and other technical assistance.

  • We translate what we learn along the way into public-domain assessments, toolkits, implementation guides, and other practical resources. Primary care teams everywhere can use these tools and resources to inform and accelerate their efforts to transform care. (Search our resource library.)

Transforming care since 1992

From our roots in transforming chronic illness care to our more recent projects to advance high-value care, the tools we’ve developed have evolved to focus on some of health care’s emerging challenges.  Learn more:

  • Chronic Illness Care 

  • Care Coordination

  • Patient-Centered Medical Home

  • Team-Based Care

  • High-Value Care

  • Assessments