Abstract
This brief highlights the major strategies, lessons learned, and outcomes from Illinois’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).
Illinois’s Goals: Improve the quality of care for children by 1) calculating, reporting and using quality measures 2) helping practices implement the patient-centered medical home (PCMH) model and improving access to electronic information on care coordination resources 3) establishing a perinatal quality collaborative and promoting exchange of perinatal health information
Insights Results
Overview of model
Illinois expanded reporting measures and use of child-focused quality measures, increasing reporting on Child Core Set measures to CMS by 10 measures between 2010 and 2016
The state promoted the adoption of primary care medical home (PCMHs) by: 1) Hosting a learning collaborative on medical home transformations to improve care for children with asthma; 2) Improving access to electronic information on care coordination services through statewide databases and secure email services; and 3) Developing a toolkit to inform practices’ strategy for transitioning to a PCMH
The state found that a more structured learning collaborative was more effective than a voluntary, flexible group learning approach; practices participating in the structured collaborative reported improvements in their Medical Home Index and in asthma care, influenza immunizations and follow-up care after emergency room visits
Illinois facilitated improvements in the quality of perinatal care by offering educational materials and quality improvement (QI) tools to clinicians and launching a collaborative that engaged 80 hospitals in data-driven QI projects
Key takeaways/implications
Insight: managed care contracts were a successful way to drive quality improvements
Challenges: resources that were created to improve referrals and cross-clinician communications were used infrequently by clinicians because of limited time and a lack of understanding about value of exchanging electronic information
