This brief highlights the major strategies, lessons learned, and outcomes from Vermont’s experience during the first 5 years of the quality demonstration funded by the Centers for Medicare & Medicaid Services (CMS) through the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA).
Vermont’s Goals: Improve quality of care for children by 1) engaging pediatric practices in the State’s advanced primary care model 2) improving use of health information technology 3) helping States develop improvement partnerships
Overview of model
Vermont expanded its “Blueprint for Health Initiative” to encourage pediatric participation; the initiative provided support for: 1) Assistance with patient centered medical home (PCMH) recognition; 2) Access to community health teams that help coordinate medical and social services; and 3) Quality feedback reports
With the demonstration and the hiring of practice facilitators, 27 out of 28 practices received PCMH recognition after implementing strategies to improve performance tracking with data, involve families in care plan development and work with social workers and care coordinators to integrate medical and social services
The State created pediatric visit planners to walk providers through their appointments and suggest preventative services that can be delivered; planners were added to the State’s electronic registry
Partnerships: Vermont and Maine implemented similar projects and discussed best practices
Challenges: 1) Several practices indicated that the PCMH recognition process was burdensome and diverted resources from other QI efforts; 2) Practices expressed concern about not having reimbursement for care coordination; and 3) Use of the electronic registry was limited because providers had difficulty connecting their EHRs to the state system