Take your practice to the next level

Why transform?

Whether your practice is new to the concept of practice transformation or in a continued advancement stage, there are many reasons to transform…

  • Improve your practice’s culture by rallying your staff around embracing changes and a commitment to performing at the highest levels
  • Enhance patient care by improving communication, data use, office efficiency and staff loyalty
  • Position your practice to be more sustainable and successful amid a changing environment including value based payment and Medicare's
    Quality Payment Program
  • Publicize the excellence you’re already performing by seeking accreditations and other formal recognition

Practices and leaders across the state are demonstrating their commitment to better health and healthcare for their patients. For many, transformation is a pathway to making the business of delivering care to patients a satisfying career choice again. This guide reflects the many opportunities available to Colorado practices: primary and specialty care.  

10 Building Blocks of High-Performing Primary Care

    Category 3: Integration
  • Integration: Behavioral Health and Community 10

    Integration: Behavioral Health and Community

    Integration: Behavioral Health and Community
    • Effective integration (behavioral health, community)
    • Comprehensive payment model
    • Ongoing learning and diffusion
  • Category 2: Advancement and Evolution
  • Care Coordination 9

    Care Coordination

    Care Coordination
    • Management of transitions and referrals
    • Care coordination as a role
    • Bi-directional communication processes
  • Prompt Access to Care 8

    Prompt Access to Care

    Prompt Access to Care
    • Reduced patient waiting
    • Timely access to needed information
    • Alternative access to team-based care for additional capacity
  • Continuity of Care 7

    Continuity of Care

    Continuity of Care
    • Empanelment
    • Measurement
    • Relationships
  • Population Management 6

    Population Management

    Population Management
    • Stratification of population based on needs
    • Team roles based on stratified needs
    • Panel management, health coaching, complex care management/ coordination
  • Patient-Team Partnership 5

    Patient-Team Partnership

    Patient-Team Partnership
    • Maximum engagement of expertise/experience of patients and caregivers
    • Effective use of shared decision making, self-management support, patient activation
    • Clinician expertise/ judgement as a part of effective partnership
  • Category 1: Foundation Building
  • Team-Based Care 4

    Team-Based Care

    Team-Based Care
    • Staff performing at the top of licensure with clear role definitions
    • Enhanced staff resources
    • Workflow maximizes use of resources
  • Empanelment 3


    • Ongoing process of assigning accountability for each active patient to a provider/team
    • Patient panels as foundation for individual/population health management
    • Relationship continuity
  • Data Driven Improvement 2

    Data Driven Improvement

    Data Driven Improvement
    • Advanced measurement and goals setting capabilities
    • Effective use of data and other quality-improvement techniques/tools
    • Optimized use of all available health information technology
  • Engaged Leadership *1

    Engaged Leadership

    Engaged Leadership
    • Clear vision, strategy, capacity, capability, and priority for change
    • Strong practice culture that stimulates innovation
    • Effective business processes to support new models of care and payment

* Value-based payment support
Adapted from: Bodenheimer T, Willard-Grace R, Ghorob A, Grumbach K. "The 10 building blocks of high-performing primary care." Ann Famn Med. 2014; 12(2):166-171.