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

Publication Year: 2018
Patient Need Addressed: Care Coordination/Management
Population Focus: Medicaid beneficiaries
Demographic Group: Child
Intervention Type: Service redesign, Technology/innovation
Type of Literature: Grey

This brief highlights the major strategies, lessons learned, and outcomes from Florida’s experience from February 2010 to February 2016 with the quality demonstration funded by the Centers for Medicare & Medicaid Services (CMS) through the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA).

Florida’s Goals: Improve quality of care for children by 1) helping practices implement the patient-centered home model 2) calculating, reporting and using quality measures 3) promoting the exchange of health information among practices 4) facilitating quality improvement projects focused on perinatal care

Insights Results

Overview of model

  • In Florida, the American Academy of Pediatrics helped pediatric PCPs transition to a patient-centered medical home (PCMH) model with group learning sessions and the development of a toolkit
  • Participating practices increased their scores on the Medical Home Index from 47.4% in 2011 to 68.8% in 2014 and saw significant increases in the percent age of adolescents receiving well-care visits and immunizations as a result
  • Practices improved care processes by: 1) Holding regular team meetings on quality improvement; 2) Seeking input from families on how to improve care; 3) Making more effective use of EHRs; 4) Introducing same day appointments; and 5) Having families fill out pre-visit questionnaires to inform the practice’s approach to a patient’s care
  • Florida expanded its reporting on quality measures, reporting 25 of the 26 Child Core Set measures to CMS which was up from 12 in 2010
  • Demonstrable improvements in the quality of perinatal care at hospitals were made by leveraging the FPQC’s efforts to engage hospitals in evidence-based QI projects and to provide them with technical assistance

    Key takeaways/implications

    • Partnerships: Florida and Illinois implemented similar projects and met monthly to share lessons learned
    • Challenges: 1) Difficulty communicating with specialists and keeping families engaged in their own care created problems for the transition to the PCMH model; and 2) Plans to establish electronic data sharing among providers was hindered by incompatibilities across stakeholders’ health information systems