New PHMI assessment tool helps CHCs chart the work ahead

Katie Coleman, MSPH, PHMI’s Practice Transformation Lead, explains the key role that the Population Health Management Capabilities Assessment Tool (PhmCAT) plays in the initiative. 

What is the PhmCAT and how is it being used?

The Population Health Management Capabilities Assessment Tool (PhmCAT) is an assessment tool developed by a collaborative workgroup which included the California Department of Health Care Services, California Primary Care Association, Regional Consortia and Health Plan representatives, and PHMI staff.

The assessment addresses multiple domains and includes questions on both foundational competencies and populations of focus. It’s designed to help understand Community Health Centers’ current population health management capacities, including strengths, opportunities for development, and focused areas of work. It is being used initially to establish each center’s starting point and priorities, and will be readministered three more times over the course of PHMI to assess how competencies are growing and when centers are ready to take their next steps.

What is the PhmCAT’s purpose?

The PhmCAT was developed for four primary reasons:

  • To engage a multidisciplinary team at each CHC to share their perspectives on the areas PHMI is focused on
  • To help CHCs and their coaches determine where they are strong and where support is most needed
  • To serve as a tool for evaluation and learning over time
  • To support building the field of population health management by having a single tool that can be used across multiple initiatives

How was it developed and what does it look like?

The workgroup began by looking across the PHMI, APM, and Health Equity Practice Transformation programs to identify common domains. They found a lot of overlap, so they mapped each domain and then identified validated surveys to address key capabilities. Though most survey questions came from existing evidence-based tools, some were developed by the workgroup.

This collaborative work resulted in a 50-item tool, each focused on a specific capability. CHCs rate themselves on a 1-10 scale for each measure, with a high rating representing something the CHC has widely distributed across their organization as well as embedded into their work flows and policies.

What’s unique about the PhmCAT? 

The assessment is being used to help launch the PHMI’s implementation work. Unlike many assessments that are done by an individual or a small leadership group, the PhmCAT is completed by all members of a core team—from executive suite staff to clinic leaders, providers, and medical assistants. Once completed, the PHMI team aggregates the responses then the practice coach goes onsite to meet with the core team to talk through where there are similar perspectives on how the organization is doing and where there might be differences of opinion. The team members sit together with their coach and talk through what’s working well and what can be improved upon from their perspectives before they map key priorities. Fundamentally, the PhmCAT is a consensus-building tool. 

People taking the assessment individually seems unusual. Why is that important?

For many at the CHCs, the PhmCAT is their first introduction to the PHMI program, providing a shared framework and language to describe the work ahead. By administering the assessment widely and making responses anonymous, people can be candid in their feedback, which accelerates the process of identifying priorities. In addition to eliciting broad participation, the PhmCAT is also helps coaches use their limited time in the clinics well by focusing on those dozen or so questions where they are a range of responses, rather than completing all 50 items together.

Is the PhmCAT already being used?

So far about 300 individuals across PHMI’s 32 sites have completed the PhmCAT. In May, coaches will visit participating CHC sites to review their PhmCAT findings reports and core teams will gather to map their work ahead.

Where can I get more information about the PhmCAT?

Learn more on our site or reach out to