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

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

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