Practice Transformation

CCHN provides various forms of technical assistance to facilitate continued transformation around components of Patient Centered Medical Home (PCMH). Practice coaches focus on enhancing the following efforts of CHCs: patient engagement, social determinants of health, collecting informative data, oral health integration, behavioral health integration, care coordination, and innovative technologies.

Team-Based Care
CCHN, in partnership with the Colorado Health Foundation, John Snow, Inc (JSI), the MacColl Center for Health Care Innovation, and Leibig-Shepherd LLC, provides technical assistance (QI coaching) to select CHCs to improve clinical efficiencies, health outcomes, and integration of services within primary care practices by optimizing existing care teams to deliver coordinated, high quality care. For more information on the Colorado Team-Based Care Initiative, click here. For more information on Team-Based Care, visit

State Innovation Model (SIM)
CCHN serves as a Practice Transformation Organization for the SIM project, working with CHCs across the state to provide technical assistance and practice facilitation for behavioral health Integration.

EvidenceNow Southwest (ENSW)
CCHN serves as a Practice Transformation Organization for the ENSW project, working with CHCs to provide technical assistance and practice facilitation to improve outcomes associated with cardiovascular disease.

Patient Centered Medical Home (PCMH)
CCHN supports Colorado CHCs in pursuing PCMH recognition by providing practice coaching, readiness assessments, application review, and training on PCMH components. CCHN has a dedicated PCMH team with content experts who have received Certified Professional in Healthcare Quality (CPHQ) and NCQA Recognized Content Expert credentials.

Click here to learn more about how CCHN can help your CHC.

QID will support Colorado’s community health centers through their PCMH journey by:

  • Developing initial gap analysis for PCMH readiness and needs
  • All staff orientation on PCMH concepts and what means for your organization
  • Review of NCQA PCMH Toolkit
  • Technical assistance in developing QI infrastructure and workflows
  • Training resources
  • Policy and document review throughout the implementation of new workflows
  • Final review of application
  • Hands on support while uploading NCQA application
  • PCMH workshops
  • Regional Learning Sessions
  • System Redesign coaching
  • Peer Learning and networking


RCHN Women’s Comprehensive Health Program

Funded by the RCHN Community Health Foundation, CCHN provides technical assistance, coaching, and practice facilitation to CHCs to improve screening rates and preventative services for female patients in Colorado CHCs, targeting specific interventions and process improvements. CCHN provides coaching to a cohort of CHCs to develop a comprehensive women’s health program, focusing on cervical cancer screening rates, abnormal follow-up, substance use screenings, depression screenings, immunization rates, pregnancy intention, and sexual orientation/gender identity screenings.

ECHO Colorado
ECHO Colorado (Extension for Community Health Outcomes) is a statewide program of training and practice support to increase the capacity to manage complex health care problems in primary care settings and to prevent disease in Colorado. In partnership with ECHO, CCHN facilitates participation by CHC staff in ECHO offerings with the aim to increase capacity for clinical patient case and disease prevention. Click here to see program offerings.

NACHC Reproductive Health
CCHN partners with National Association of Community Health Centers (NACHC) to provide technical assistance to CHCs on the use of clinical decision support in their electronic health record system in order to improve the identification and treatment of women at risk for unintended pregnancy.

Transforming Clinical Practice Initiative (TCPI)
CCHN serves as a Practice Transformation Organization for TCPI, currently working with specialty practices to achieve practice transformation, coordination of care systems and improvement on quality metrics in preparation for upcoming value-based reimbursement through the Medicare’s Quality Payment Program.

Please contact Jessica Sanchez,, for additional information.