Abstract
This brief highlights the major strategies, lessons learned, and outcomes from Massachusetts’s experience from February 2010 to May 2015 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).
Massachusetts’ Goals: Improve quality of care for children by 1) helping practices implement the patient centered medical home model 2) reporting on child-focused quality measures 3) developing a coalition to lead quality improvement efforts in the State
Insights Results
Overview of model
Massachusetts helped 13 practices transition to the primary care medical home (PCMH) model by developing quality improvement teams within practices, transitioning current staff into new roles as care coordinators and improving electronic health record (EHR) use
Newly transitioned care coordinators were trained by experienced coordinators employed by the Department of Public Health; care coordinators followed up with the caregivers of children with autism, ADD and asthma to see if the children received the services that they needed
Demonstration practices increased their Medical Home Index scores at a faster rate than comparison practices, the new care coordinators were found to improve care
Massachusetts increased reporting on Child Core Set Measures and developed quality measure reports for practices, policymakers and families
The state formed the Child Health Quality Coalition to convene stakeholders to identify priorities for child health quality improvement and develop resources to help practices and families improve care coordination
Key takeaways/implications
Insight: families’ input on PCMH transformation, quality reporting and quality improvement (QI) priorities proved helpful and practices recognized the value of engaging with families
Challenges: Practices expressed concern about continuing care coordination after the demonstration because of a lack of reimbursement
