Abstract
This brief highlights the major strategies, lessons learned, and outcomes from Pennsylvania’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).
Pennsylvania’s Goals: Partner with large healthcare systems to improve the quality of care for children by 1) implementing electronic screening questionnaires 2) encouraging improvement on child-focused quality measures 3) improving electronic health record (EHR) functionality
Insights Results
Overview of model
Pennsylvania partnered with Children’s Hospital of Philadelphia (CHOP) and Geisinger Health System to implement new electronic screeners into EHRs to improve screening rates (screenings for developmental delays, autism, ADHD, etc.)
Between 2011 and 2013, developmental screening rates for children under age 3 at CHOP increased from 6.7% to 48.2%
CMS’s Model Children’s EHR Format was introduced into 4 health systems and a federally qualified health center (FQHC) to include patient portals, alerts for immunizations, and fields for tracking social and family history
The State provided financial incentives to providers to improve child-focused quality measure reporting and performance (a focus on well-child visits, immunization status, body mass index and preventive dental services)
Key takeaways/implications
Physicians participating in the financial incentives program were more likely than their counterparts to generate internal quality reports and indicate that quality reports were effective
Insight: Health systems that involved cross-functional teams in quality measurement and information technology efforts made more improvements than those who relied on vendors or had less integrated teams
Challenges: 1) Improving electronic systems was challenging for health systems given competing demands for resources, limited provider time and vendor’s resistance; and 2) Programming EHRs to calculate measures was resource intensive and would have been difficult without financial assistance
