What We Learned | Agency for Healthcare Research & Quality (AHRQ)

What We Learned | Agency for Healthcare Research & Quality (AHRQ)

New CHIPRA Evaluation Highlight Focuses on Learning Collaboratives

AHRQ has published the 13th Evaluation Highlight from the Children’s Health Insurance Program Reauthorization Act (CHIPRA) Quality Demonstration Grant Program, now available on the national evaluation website under What We Learned. This Highlight describes the experiences of nine CHIPRA quality demonstration states that implemented learning collaboratives to advance the quality of children's health care in participating child-serving practices. States and practices found that a combination of strategies was needed to help practices improve medical home capacity and/or performance on clinical quality measures. Those strategies included offering incentives to encourage practice participation in the collaborative, combining classroom and interactive learning to keep practices engaged in the collaborative and providing individualized practice facilitation and support. AHRQ is leading the national evaluation of the CHIPRA Quality Demonstration Program. The Centers for Medicare & Medicaid Services funds the evaluation. If you have questions or comments, please contact the national evaluation team via email.

The National Evaluation team is disseminating the CHIPRA quality demonstration States' strategies, lessons learned, and outcomes through four mechanisms:

• Evaluation Highlights
• Implementation Guides
• Journal Articles
• Presentations and Webinars
• Additional Resources

Evaluation Highlights

The national evaluation team is producing a series of issue briefs that frame the most pertinent evaluation findings for a variety of audiences concerned with children's health care quality. These 4-6 page briefs, entitled Evaluation Highlights, will include both descriptive and analytic findings depending on the topic and time period of the demonstration, and will be posted to this page as they become available.

Evaluation Highlight No. 13: How did CHIPRA quality demonstration States employ learning collaboratives to improve children’s health care quality?

This Evaluation Highlight is the 13th in a series that presents descriptive and analytic findings from the national evaluation of the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) Quality Demonstration Grant Program. This Highlight focuses on lessons learned from nine States—Alaska, Florida, Idaho, Maine, Massachusetts, North Carolina, Oregon, Utah, and West Virginia. These States implemented learning collaboratives and subsequently reported quantifiable improvements in medical home capacity and/or health care quality among the 137 child-serving primary care practices that participated in the CHIPRA quality demonstration. The analysis is based on work completed by States during the first 4.5 years of their 5-year demonstration projects.

 PDF version - 813.71 KB or HTML text

This Evaluation Highlight includes a supplement that provides an overview of the learning collaboratives in each of the nine States, including their similarities and differences.  PDF version - 318.06 KB or HTML text

Evaluation Highlight No. 12: How are CHIPRA quality demonstration States improving perinatal care?

 PDF version - 649.48 KB or HTML text

Evaluation Highlight No. 11: How are CHIPRA quality demonstration States using quality reports to drive health care improvements for children?

 PDF version - 667.67 KB or HTML text

Evaluation Highlight No. 10: How are CHIPRA quality demonstration States testing the Children's Electronic Health Record Format?

 PDF version - 655.16 KB or HTML text.

Evaluation Highlight No. 9: How are CHIPRA quality demonstration States supporting the use of care coordinators?

 PDF version - 731.19 KB or HTML text.

Evaluation Highlight No. 8: CHIPRA quality demonstration States help school-based health centers strengthen their medical home features

 PDF version - 595.3 KB or HTML text.

Evaluation Highlight No. 7: How are CHIPRA quality demonstration States designing and implementing caregiver peer support programs?

 PDF version - 585.23 KB or HTML text.

This Evaluation Highlight includes a supplement that describes the features of peer support programs across the States. PDF version - 156.11 KB or HTML text.

Evaluation Highlight No. 6: How are CHIPRA quality demonstration States working together to improve the quality of health care for children?

 PDF version - 549.27 KB or HTML text.

This Evaluation Highlight includes a supplement that describes the multi-State partnerships and the projects they are developing.    PDF version - 264.16 KB or HTML text.

Evaluation Highlight No. 5: How are the CHIPRA Quality Demonstration States encouraging health care providers to put quality measures to work?

 PDF version - 655.33 KB  or HTML text.

Evaluation Highlight No. 4: How the CHIPRA quality demonstration elevated children on State health policy agendas

 PDF version - 578.52 KB or HTML text.

Evaluation Highlight No. 3: How are CHIPRA Quality Demonstration States working to improve adolescent health care?

 PDF version - 547.59 KB or HTML text.

Evaluation Highlight No. 2: How are States and evaluators measuring medical homeness in the CHIPRA Quality Demonstration Grant Program?

 PDF version - 924.92 KB or HTML text.

This Evaluation Highlight includes a supplement that provides information on two medical home measurement tools, the creation of a cross-State database, the methods for collecting the data analyzed in this Highlight, and explores the MHI-RSF in six demonstration States  PDF version - 164.77 KB or HTML text.

The Medical Home Index-Revised Short Form (MHI-RSF) is a medical home assessment tool being used in the CHIPRA quality demonstration.  PDF version - 563.9 KB ; HTML text;  The Medical Home Index: Revised Short Form: Pediatric[ - 133.79 KB]

Evaluation Highlight No. 1: How are CHIPRA demonstration States approaching practice-level quality measurement and what are they learning?

PDF Version [  - 531.24 KB] or HTML text.

This Evaluation Highlight includes a supplement that describes the practice-level reporting efforts of the States featured in this Highlight. PDF Version [  - 229.19 KB]  or HTML text.

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Implementation Guides

Designing Care Management Entities for Youth with Complex Behavioral Health Needs

This Implementation Guide provides information about the process of designing care management entities (CMEs), which are designed to coordinate services provided by the many State agencies that serve youth with complex behavioral health needs. By ensuring services are comprehensive but not duplicative, CMEs can improve outcomes for these youth and their families and lower costs to States. This guide may be helpful to States interested in implementing or improving CMEs and for county agencies if they are responsible for financing behavioral health or social services in the State.

Engaging Stakeholders to Improve the Quality of Children's Health Care

This Implementation Guide includes suggested steps and tips for implementing initiatives for improving child health care quality from the CMS-funded national evaluation of the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) Quality Demonstration Grant Program. This guide focuses on the stakeholder engagement efforts inGeorgia, Idaho, and Massachusetts, and is designed to help State officials and other program administrators engage and partner with stakeholders in their own child health care quality improvement initiatives. It provides a five-step approach to engaging stakeholders, breaking down each step into smaller tasks with key points and resources to consider throughout the process.

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Journal Articles

The national evaluation team is producing several journal articles that synthesize findings from several States and address topics of interest to the community of pediatric health services researchers.

Nine States' Use of Learning Collaborative to Improve Children's Health Care Quality in Medicaid and CHIP 

This article in the November 2013 Academic Pediatrics supplement on quality improvement examines how nine CHIPRA quality demonstration States are using learning collaboratives to improve health care quality for children. The various approaches, goals, and challenges described in the article offer lessons that other States may find useful in creating their own learning collaboratives.

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Presentations and Webinars

Improving Quality of Care for Children: Early Lessons from the CHIPRA Quality Demonstrations 

Members of the national evaluation team presented at AcademyHealth’s 2014 National Child Health Policy Conference. Slides from each of the presenters from the national evaluation team are posted.

CMS CHIPRA Quality Demonstration Grant Program Webinar Series

In the summer and fall of 2013 CMS conducted a five-part webinar series to share early findings from the CHIPRA Quality Demonstration Grants. The first webinar provides an overview of the CHIPRA quality demonstration, while the other four describe the experiences of the grantees.

Presentation from the CMS Medicaid and CHIP Quality Conference, June 2012

On June 15, 2012, Henry Ireys presented an update of the national evaluation activities to the CHIPRA quality demonstration States at the second annual CMS Medicaid and CHIP Quality Conference in Baltimore, MD. The presentation provided updates on the national evaluation team's data collection activities, early observations from site visits, Web page updates, and next steps. The slide deck is available here and as a PDF file (229 KB; ).

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Additional Resources

CMS Web site about the CHIPRA Quality Demonstration Grant Program

In February 2010, the Centers for Medicare & Medicaid Services (CMS) awarded 10 grants, funding 18 States, to improve health care quality and delivery systems for children enrolled in Medicaid and the Children's Health Insurance Program (CHIP). CMS provides overviews of each demonstration State's funding and projects on InsureKidsNow.gov.

CHIPRA Children's Health Care Quality Measurement and Improvement Activities

This Web page, hosted on AHRQ's Web site, provides information on the following activities: (1) identifying an initial core set of children's health care quality measures for voluntary use by Medicaid and CHIP programs, (2) implementing the CHIPRA Pediatric Quality Measures Program using grants and contracts, and (3) evaluating CMS's Quality Demonstration project awards and creating a Model Children's Electronic Health Record Format.

Please note: This Web site uses the term "national evaluation" to distinguish this evaluation of the entire demonstration program from evaluations commissioned or undertaken by grantees. The word "national" should not be interpreted to mean that findings are representative of the Nation as a whole.

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Page last reviewed June 2015

Internet Citation: What We Learned. June 2015. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/policymakers/chipra/demoeval/what-we-learned/index.html