I am an expert in primary care and innovative models of care delivery and financing. My research spans new models of care, health disparities, health literacy, quality improvement and patient reported outcomes. From 2014-2016, I led a group at the Center for Medicare and Medicaid Innovation to help support new models of care delivery and financing. I have a long history of research and quality improvement at local, regional and national levels. I was the principal investigator for the North Carolina Infrastructure for Maintaining Primary Care Transformation (NC IMPaCT) grant from AHRQ. I also led the design team and was a national improvement advisor for the Improving Performance in Practice (IPIP) program for the boards and specialty societies of internal medicine, family medicine and pediatrics. IPIP helped practicing primary care physicians improve care systems through working in improvement networks, measuring and sharing performance data and receiving improvement education and training. As part of IPIP, I also provided technical assistance to the RWJF Aligning Forces for Quality program transforming healthcare in 17 communities across the United States. I was also an improvement advisor to the Cincinnati Beacon Community PCMH and diabetes quality improvement collaborative. I currently lead the evidence team for Heart Health Now supporting transformation in 250 practices across North Carolina. I have also researched self-management interventions for patients with low-literacy and focused on chronic diseases like diabetes, heart failure, COPD, and asthma. I focus on patient-physician communication and health system design to achieve better outcomes for vulnerable populations. I work in health literacy includes epidemiological studies, systematic reviews, communication tool development and clinical trials. I also led a practice-based intervention to reduce hypertension disparities funded by NHLBI. I am the lead author of the AHRQ Health Literacy Universal Precautions Toolkit.