Reports and Resources

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  Contents

• Summary of the Evaluation Design Plan
• Evaluation Highlights
• Additional Resources
• Resources Provided by the Demonstration States 

Evaluation Design Plan

This design plan describes the national evaluation team's current plans for evaluating the CHIPRA Quality Demonstration Grant Program. It is a "living document" that will evolve as the States' programmatic and evaluation activities are shaped by actual implementation experiences. At this point, grantees and partner States vary widely with respect to implementation schedules for specific activities. This document describes the evaluation design based on information available from the States as of mid-March 2012.

• Summary of the Evaluation Design Plan [ - 151.35 KB] , July 2012.

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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. 1: How are CHIPRA demonstration States approaching practice-level quality measurement and what are they learning?

January 2013

This Evaluation Highlight is the first in a series of reports that present descriptive and analytic findings from the national evaluation of the CHIPRA Quality Demonstration Grant Program. In this Highlight, we discuss the early accomplishments, challenges, and lessons learned from the following four States pursuing practice-level quality measurement: Maine, Massachusetts, North Carolina, and Pennsylvania. The administrative and technical steps needed to calculate quality measures at the practice level are different in critical ways from the steps needed to report quality data at the health plan or State level. To help other States that may be considering or pursuing practice-level quality measurement and improvement, we highlight these four States’ approaches to selecting measures, adapting the selected measures for practices, and collecting the needed data. Our analysis is based on work completed by the States during the first 2 years of their 5-year demonstration projects. As a supplement to the Evaluation Highlight, we have provided additional details about the States’ specific approaches to practice-level reporting and a list of helpful resources.

• Evaluation Highlight No. 1: How are CHIPRA demonstration States approaching practice-level quality measurement and what are they learning? January 2013, available as a PDF Version [ - 531.24 KB] or HTML text.
• Four States' approaches to practice-level quality measurement and reporting: Supplement to Evaluation Highlight No. 1, January 2013, available as a PDF Version [ - 229.19 KB] or HTML text.

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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.
• 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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Resources Provided by the Demonstration States

The Medical Home Portal

The Medical Home Portal aims to provide ready access to reliable and useful information for professionals and families to help them care and advocate for children with special health care needs (CSHCN) as partners in the Medical Home model. The Portal offers detailed information about many chronic conditions in children and conditions identified through newborn screening programs, along with information on providing a comprehensive medical home. It offers information for families of children with chronic conditions about how to care and advocate for them and their siblings, how to find services and resources, and how to manage their many transitions in development and service systems. The Portal also compiles information about relevant local services in collaborating States to enable both clinicians and families to recognize and take advantage of valuable service providers. Representatives in Utah and Idaho are anxious to work with other States and regions to make their services information available within the Portal to enhance its value to local users. Please contact Chuck Norlin, MD, chuck.norlin@hsc.utah.edu with questions or interest.

New Mexico School-Based Health Center 2010-2011 Welligent Visit Analysis

Written by Kevin Koenig, Tara Trudnak, and Gerry Fairbrother
As part of the evaluation of the Colorado/New Mexico CHIPRA demonstration project, medical encounter data were analyzed for adolescents aged 14-19 from 61 School-Based Health Centers in New Mexico. This report summarizes the SBHC services delivered in the 2010-2011 school year and is intended to inform practices at the local level and policy at the State level.

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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These reports, issue briefs, and presentations are available in PDF form only. Those using assistive technology may not be able to fully access information in these files. For assistance, please contact us.

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.