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

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