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

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 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