It has been demonstrated in a statistically significant way that patients of primary care practices embracing a "performance improvement champion" have better health outcomes. Key aspects of success include leveraging person-driven outcomes and using standardized measurement. In a study of patients on care planning and self-care support, patients with uncontrolled blood pressure patients were asked to select meaningful functional/ practical achievements tied to an activity (e.g., reaching a healthy BMI could help a patient to fit into a wedding dress). Standardized HEDIS^® measure specifications for hypertensive BP control ensured that the denominator included only active patients who met clinical criteria for hypertension.

Through identification of and effective responses to barriers to change and respectful communication, embedded provider champions (physician, physician assistant, nurse practitioner) became advocates of chronic condition management best practices specifically and of the PCMH framework in general. Principal findings included: 1.) BP control rates differed between champion and nonchampion practices and between levels of champion practice engagement; 2.) champion practices demonstrated significantly lower “no-read” rates; and 3.) mean systolic BP readings were statistically significantly different in patients of champion vs. nonchampion practices. Analysis also highlighted the beneficial effect for Black non-Hispanic patients. Cerebralvascular accident, coronary heart disease and all-cause mortalities were positively affected by the BP control achieved by champion practices. This work provided an important foundation for addressing more complex aspects of condition management, such as stage 2 hypertension.