State at a Glance: Maine

National Evaluation of the CHIPRA Quality Demonstration Grant Program

Learn more about the CHIPRA quality demonstration projects being implemented in Maine.

Table of Contents:

Overview

As one of the 10 grantees, Maine is working with Vermont in a two-State partnership 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.
  • Promoting the use of health information technology (IT) to enhance service quality and care coordination.
  • Implementing a more comprehensive provider-based model of service delivery.

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Maine's Objectives

Maine's improvements on the reporting and use of the initial core set of children quality measures will build on its continuing efforts to integrate early and periodic screening, diagnosis, and treatment (EPSDT) data into pediatric electronic health records (EHRs). Its health IT project involves implementing an electronic comprehensive health assessment (CHA) for children in the State's foster care system. Maine will also extend current statewide efforts to promote medical homes by enhancing access to child-specific learning collaboratives for selected pediatric and child-serving practices.

Working with the Initial Core Set of Children's Quality Measures

Maine's goal is to enhance the State's current quality performance measurement and incentive payment systems to include children's quality measures, with the goals of: reducing unnecessary variation in pediatric care, aligning payment and financial incentives with these measures, and improving child heath. This process will integrate EPSDT Bright Futures Exit Disclaimerreporting to produce clinical measures not available through claims or registry data.

Using Health IT to Improve Child Health Care Quality

Maine is promoting health IT usage with two approaches. The first involves collecting and reporting EPSDT/Bright Futures preventive measures from electronic clinical records and linking data systems within Maine's Department of Health and Human Services Exit Disclaimer to child-serving practices and health systems. The State is developing infrastructure to receive clinical data from health systems and to pilot e-measure specifications to ultimately enhance data collection alignment, coordination, and planning.

Second, Maine will design, implement, and evaluate a CHA for children in Maine's foster care system. Through this automated system, information will be available to key health and social service providers with secure access regarding preparation and availability of the CHA. To assist in this effort, Maine has assembled a work group consisting of multiple stakeholders.

Assessing a Provider-Based Model of Care

Maine is building on the State's ongoing Patient-Centered Medical Home (PCMH) pilot program that began prior to the CHIPRA award. It involves 22 adult and four pediatric practices, all of which are participating in medical home-focused learning collaboratives. The CHIPRA grant award provides additional support for pediatric-specific learning sessions, automating Bright Futures in pediatric practices' EHRs, and developing a standardized list of quality measures. The four PCMH pediatric practices have volunteered to (1) track selected measures, (2) pilot Bright Futures in EHRs, and (3) participate in the learning sessions.

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Evaluation Questions

The national evaluation team will gather information from Maine to address a wide range of questions about the implementation and outcomes of their efforts including:

  • How has standardizing pediatric quality measures affected provider operations and performance?
  • How did Maine integrate data on EPSDT services into pediatric EHRs?
  • To what extent were Maine's efforts to enhance the child focus of its ongoing medical home project successful in improving the quality of health care for children?
  • What are the key lessons from Maine's experience that would be useful for other States?

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Additional Resources

Maine Pediatric and Family Practice Survey Chartbook

Written by Martha Elbaum Williamson, Kimberley Fox, and Stuart Bratesman
As part of the Maine CHIPRA demonstration grant’s “Improving Health Outcomes for Children” (IHOC) initiative, the University of Southern Maine surveyed pediatric and family practices about how they use data, clinical guidelines, and office systems to monitor and improve children’s health care quality. The Web-based survey was conducted in the winter of 2011-2012 and sent to practice man­agers at a sample of 168 practice sites, of which 64 percent responded. This report summarizes baseline survey results for more than one-quarter of family practices and nearly two-thirds of all pediatric practices in Maine. In 2014, a followup survey will be conducted to assess how quality improvement has changed in child-serving practices statewide over time in areas targeted for improvement by IHOC (e.g., use of Bright Futures and State registries) and within subgroups, including practices participating in IHOC learning sessions.

Bright Futures As-Is Assessment: How Child-Serving Practices, Health Systems, and the State of Maine Use and Exchange Specific Clinical Data Related to Child Health Quality Measures

Written by Martha Elbaum Williamson, Kyra Chamberlain, Jonathan Ives, and Jin Liao
As part of the Maine CHIPRA demonstration grant’s Improving Health Outcomes for Children (IHOC) initiative, Maine conducted a study of how Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) and other clinical data are currently entered, used, and exchanged electronically through information systems at selected pediatric practices and health systems, the State of Maine, and the State’s designated health information exchange, HealthInfoNet. This report summarizes the findings of this “as-is” assessment, which is intended to inform IHOC efforts to enhance electronic data exchange and child health measure calculation for EPSDT-related measures.

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Learn More

This information is current as of March 2012, slightly more than 2 years after the grant award. To learn more about the projects that Maine is implementing under the CHIPRA Quality Demonstration Grant Program, please contact:

Joanie Klayman, LCSW, CHIPRA Project Director
Cutler Institute for Health and Social Policy
Muskie School of Public Service, University of Southern Maine
P.O. Box 9300, Portland, Maine 04104-9300
207-780-4202
jklayman@usm.maine.edu

To learn more about the national evaluation of the CHIPRA Quality Demonstration Grant Program, send an email to CHIPRADemoEval@ahrq.hhs.gov.

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Current as of April 2013
Internet Citation: State at a Glance: Maine: National Evaluation of the CHIPRA Quality Demonstration Grant Program. April 2013. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/policymakers/chipra/demoeval/demostates/me.html