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

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