The National Evaluation of the CHIPRA Quality Demonstration Grant Program: Spotlight on Alaska

Publication Year: 2018
Patient Need Addressed: Care Coordination/Management, Food insecurity, Long-term services and supports, Patient satisfaction/engagement
Population Focus: Medicaid beneficiaries
Demographic Group: Child
Intervention Type: Service redesign, Technology/innovation
Type of Literature: Grey
Abstract

This brief highlights the major strategies, lessons learned and outcomes from Alaska’s experience in the quality demonstration funded by the Centers for Medicare and Medicaid Services (CMS) through the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) from February 2010 to August 2015.

Alaska’s Goals: Improve the quality of care for children by 1) helping practices implement the patient-centered medical home model 2) increasing the use of health information technology and 3) encouraging improvement on child-focused quality measures

Insights Results

Overview of model

  • Participating practices hired care coordinators to improve care for children with special needs and link children with community resources (e.g., parent support groups and food assistance)
  • Care coordinators were highly valued and each practice raised its Medical Home Index (MHI) score
  • The state enhanced the capacity of electronic health records (EHRs) to better track special needs patients, to create developmental screening templates, and to monitor quality measures
  • Alaska used the Core Set of Children’s Health Quality Measures for Medicaid and CHIP to drive and measure quality improvements
  • One practice used Core Set Data to better track well-child visits and mail reminders to families, increasing the proportion of children having two well child visits from 15% to 28% in one year

    Key takeaways/implications

    • Partnerships: Oregon and West Virginia implemented similar projects and participated in the sharing of best practices
    • Challenges: 1) Care coordinators were sometimes hard to integrate into workflows; and 2) Staff turnover, administrative data issues and limited EHR capabilities were barriers to reporting on Core Set measures