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

Publication Year: 2018
Patient Need Addressed: Behavioral health, Care Coordination/Management, Chronic Conditions, Substance Use
Population Focus: Medicaid beneficiaries
Demographic Group: Child
Intervention Type: Best practices, Service redesign
Type of Literature: Grey

This brief highlights the major strategies, lessons learned, and outcomes from Oregon’s experience during the quality demonstration funded by the Centers for Medicare & Medicaid Services (CMS) through the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) from February 2010 to August 2015.

Oregon’s Goals: Improve the quality of care for children by 1) reporting on child-focused quality measures 2) implementing the patient-centered medical home model 3) improving the use of electronic health records

Insights Results

Overview of Resource

  • Oregon hired facilitators to help rural and urban family practices implement components of the patient centered medical home (PCMH) model and guide quality improvement (QI) activities; a learning collaborative was used to share best practices
  • Practices implemented new screening tools to identify children with special healthcare needs (e.g., depression, substance abuse)
  • Practices pursued a range of strategies to coordinate care that included: 1) Hiring care coordinators or transitioning current staff into these roles; 2) Developing care plans specifically for certain conditions (e.g. asthma); 3) Connecting caregivers to community resources; 4) Educating caregivers on how to manage chronic conditions at home; 5) Developing strategies to identify children due for follow-up care and tracking whether specialty care was received; and 6) Collected data on families’ experiences and formed caregiver advisory groups
  • As a result, all 8 participating practices achieved the highest level of recognition in the State’s medical home program

    Key takeaways/implications

    • Partnerships: Alaska and West Virginia implemented similar projects and share best practices
    • Challenges: 1) Practices were concerned about continuing care coordination after the demonstration because of two reasons: state priorities might change and reimbursement for care coordination of children was not available; and 2) Some members of care teams did not adopt the use of new screening tools because they did not know how to use them or did not appreciate the usefulness of the tools