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

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

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