Abstract
This brief highlights the major strategies, lessons learned, and outcomes from Idaho’s experience during the quality demonstration funded by the Centers for Medicare & Medicaid Services (CMS) through the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) from February 2010 to February 2016.
Idaho’s Goals: Improve the quality of care for children by 1) helping practices implement the patient-centered medical home (PCMH) model 2) promoting the use of health information technology 3) establishing a pediatric improvement partnership
Insights Results
Overview of model
Idaho help transition three pediatric practices to PCMHs to improve care for children with special healthcare needs: 1) By providing technical assistance; 2) Supporting care coordination staff; 3) Introducing family partners into practices; and 4) Developing a primary care medical home (PCHM) initiative in 4 additional rural practices
Care coordinators attended learning collaboratives, linked patients with community resources and made reminder calls to patients; their role was valued by the practices and their positions were sustained after the demonstration
Family partners were typically compensated parents of special needs children intended to advise providers on how to provide more family-centered care and peer support
Idaho established the Idaho Health and Wellness Collaborative for Children to bring stakeholders together to invest in using measurement-based efforts to improve quality
The Collaborative held 8 learning collaboratives for 140 clinicians on pediatric topics, participation in the learning sessions was linked to measurable improvements in the use of best practices and the quality care
Use of depression screening after the collaborative increased from 2% to 51% among 60 clinicians and substance abuse screenings increased from 18% to 58%
Key takeaways/implications
Partnerships: Idaho implemented a similar project as Utah, they met regularly to share best practices
Challenges: 1) Practices struggled to integrate family partners because of clinician resistant to working with lay advisors and difficulty with finding parents with available time and skills; and 2) Idaho’s attempt to exchange immunization data with Utah was hindered by Idaho law prohibiting the bi-directional exchange of vaccine information
