State at a Glance: Massachusetts
Massachusetts is featured in the following reports:
- Evaluation Highlight No. 1: How are CHIPRA demonstration States approaching practice-level quality measurement and what are they learning?
- Evaluation Highlight No. 2: How are States and evaluators measuring medical homeness in the CHIPRA Quality Demonstration Grant Program?
- Evaluation Highlight No. 4: How the CHIPRA quality demonstration elevated children on State health policy agendas
- Evaluation Highlight No. 9: How are CHIPRA quality demonstration States supporting the use of care coordinators?
- Evaluation Highlight 11: How are CHIPRA quality demonstration States using quality reports to drive health care improvements for children?
- Evaluation Highlight No. 13: How did CHIPRA quality demonstration States employ learning collaboratives to improve children’s health care quality?
- Manuscript: Nine States' Use of Collaboratives to Improve Children's Health Care Quality in Medicaid and CHIP
- Implementation Guide No. 1: Engaging Stakeholders to Improve the Quality of Children’s Health Care
Learn more about Massachusetts's CHIPRA quality demonstration projects on this page:
As one of the 10 grantees, Massachusetts is working to implement projects in three of the five grant categories:
- Showing how a core set of children's quality measures can be used to improve quality of care for children.
- Implementing a more comprehensive provider-based model of service delivery.
- Testing an approach to quality improvement of a State's own design.
Massachusetts will (1) test the initial core set of children's quality measures using multiple data sources; (2) produce performance reports for practices, policymakers, and families and seek feedback on the reports; (3) support medical home transformation at a set of practices and support sustainability and spread of medical home concepts; and (4) build a coalition of key stakeholders to champion and advocate for measuring and improving child health care quality in the Commonwealth.
Working with the Initial Core Set of Children's Quality Measures
Massachusetts will calculate and report on all of the initial core set of children's quality measures twice, with the first report produced by the spring of 2014 and the second report targeted for the fall of 2014. Practices participating in Massachusetts's demonstration are using an online medical record abstraction tool developed for the grant to collect measure data. The State is also using data from Medicaid and CHIP administrative and encounter datasets, the State's birth record and hospital discharge data sets, and the State's new All Payer Claims Database set to calculate the measures. Massachusetts will produce reports on the core measures at the practice-level and gather input from practices on the measure set's usefulness in establishing performance goals and identifying quality improvement needs. The State also will develop and produce reports on the core measures for families to inform them about the quality of care provided for children in Massachusetts and encourage them to become more involved in quality improvement efforts. The State will gather information from both English- and Spanish- speaking families about the usefulness of the core measures set in accomplishing these objectives.
Assessing a Provider-Based Model of Care
In December 2013, Massachusetts completed the implementation of a 29-month-long Learning Collaborative with 13 practice sites aimed at improving the quality of care for typically developing children as well as those with special health care needs. The 13 practice sites represented diversity in geographic location, practice size, and practice type. The practices received financial support for participating in learning sessions and monthly action period calls and meetings. Each practice convened a team consisting of a practice transformation facilitator, senior leader, a provider champion, and one to two family partners. The practice transformation facilitators were selected as the primary internal change agent at the practice. They had various backgrounds and practice roles and received additional targeted support to help with practice transformation. In addition, each practice team also received care coordination support from staff at the Department of Public Health's Program for Children and Youth with Special Health Care Needs. Practices used data they collected and information from Patient Experience Surveys administered by the grant team to focus and drive improvement activities.
The Massachusetts's evaluation team for the CHIPRA demonstration is gathering qualitative and quantitative data from practices and families to evaluate its transformation support approach and the impact of medical home transformation on patients and families. In the final year of the grant, the Massachusetts team is focusing on efforts to sustain and spread the transformation work undertaken by the participating practices.
Testing an Approach to Quality Improvement of Massachusetts' Own Design
Massachusetts formed a statewide, multi-stakeholder pediatric coalition: the Massachusetts Child Health Quality Coalition (CHQC). The CHQC convenes a broad set of stakeholders including primary care and specialist providers, parent and family advocates, hospitals, health plans, health professional groups, State and local agencies, community organizations, and policy experts. The CHQC provides a neutral setting for stakeholders to discuss and come to a shared understanding of pediatric health care priorities across Massachusetts.
The CHQC completed a gap analysis and identified three areas in which broad stakeholder collaboration could support needed improvement: care coordination, communication, and quality measurement. To support change, the CHQC identified elements of care coordination believed to be important and is working with various organizations to implement and measure the effectiveness of those elements. The group is also working on developing a Communication and Confidentiality Guide to support team-based care delivery and increase the understanding of confidentiality and privacy issues from multiple perspectives, including those of families and adolescents. The CHQC is also developing templates for new measures in the area of care coordination for children with behavioral health needs. In addition, the CHQC worked to promote pediatric issues in health policy and other forums that have a tendency to under-represent pediatrics. It has also provided input on several important policies and programs under development in the Commonwealth.
The grant evaluation team for the Massachusetts CHIPRA quality demonstration has obtained input from the CHQC members along the way and Massachusetts has used that input to guide formative improvements in its approach to working with the CHQC. In the final year of the grant, the CHQC is working with the State to develop a sustainability plan so the group can continue their work after the end of the grant-funded period.
The national evaluation team will gather information from Massachusetts to address a wide range of questions about the implementation and outcomes of its efforts, including:
- How did Massachusetts structure its reports on core measures and what was the effect?
- In what ways did parent partners contribute to the medical home transformation teams?
- Did the Massachusetts medical home project enhance quality of care for children?
- What are the key lessons from Massachusetts's experience that would be useful for other States?
This information is current as of February 2014, slightly more than 4 years after the grant award. To learn more about the projects being implemented in Massachusetts under the CHIPRA Quality Demonstration Grant Program, please contact:
Louise Bannister, CHIPRA Grant Project Director
529 Main St., Charlestown, MA 02129
To learn more about the national evaluation of the CHIPRA Quality Demonstration Grant Program, send an email to CHIPRADemoEval@ahrq.hhs.gov.