Abstract
This brief highlights the major strategies, lessons learned, and outcomes from Utah’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).
Utah’s Goals: Improve the quality of care for children by 1) developing a regional pediatric quality improvement partnership 2) helping practices implement the patient-centered medical home model 3) promoting the use of health information technology
Insights Results
Overview of model
Utah worked with the existing Utah Pediatric Partnership to Improve Healthcare Quality to hire quality improvement QI coaches, develop learning criteria and offer learning collaboratives on a variety of health topics (immunization rates, primary care medical home (PCMH) transformation and care coordination for children with special needs); the demonstration involved more than 250 clinicians and 9 practices
The learning collaborative on the PCMH model included trainings on: 1) Improving referral processes; 2) Developing care plans; 3) Transitioning to adult healthcare; and 4) Managing chronic conditions
Practices hired care coordinators and engaged family partners (parents of special needs children) to advise them on how to provide more family-centered care and provide peer support to other families
Participating practices improved their self-reported Medical Home Index Scores and QI capacity
Utah developed a portable pediatric medical record and found an alternative method for securely transmitting immunization data to Idaho
Key takeaways/implications
Partnerships: Utah had a similar project with Idaho and shared best practices
Challenges: 1) Practices struggled to implement family partners because of clinicians’ resistance to working with lay advisors and difficulties with finding parents with available time and appropriate skills; and 2) Utah’s efforts to develop a health information exchange was hindered by vendor turnover and prolonged data-sharing negotiations with provider groups
