Key Lessons from the National Evaluation of the CHIPRA Quality Demonstration Grant Program

In conclusion

The CHIPRA Quality Demonstration Grant program was an ambitious Federal effort to test promising strategies for improving quality of care for children enrolled in Medicaid and CHIP. States implemented a wide array of projects that provided many examples of those promising strategies. The national evaluation findings underscore the importance of marshaling resources over several years to enhance States’ capacities to report and use quality measures, deal with challenges related to evolving Federal and State policies, address the thorny problems of implementing new health IT applications, and develop the stakeholder relationships that underpin successful efforts to transform service delivery systems.

Many elements of the demonstration programs are likely to endure because States and their partners have found additional sources of support. As Federal and State policymakers chart new directions to stimulate innovation in service delivery systems, they can look to the lessons learned from this demonstration to find promising paths to improving quality of care for children.  

Evaluation Methods

Guided by a detailed plan that specified research questions and methods for data collection and analysis, the national evaluation team gathered a substantial amount of qualitative and quantitative data about the demonstration States’ projects. Qualitative data sources included program documents and reports; multiple interviews with program staff, participating practices, and other stakeholders during two rounds of site visits; and focus groups with parents in selected States. Quantitative data sources included Medicaid administrative and claims data and original survey data from physicians in selected States. Further details regarding our evaluation methods are available at

Learn More

This document represents a synthesis of findings from multiple publications, conference presentations, and webinars, which are available at AHRQ’s Web site for the National Evaluation of the CHIPRA Quality Demonstration Grant Program:

Specifically, this Web site includes our Evaluation Highlights, Implementation Guides, State Spotlights, special innovation features, conference presentations, and links to journal articles, as well as reports from participating States.


  1. Throughout this summary, the term children is used to refer to both children and adolescents.
  2. No-cost extensions varying from 3 to 12 months in length were awarded to 14 of the demonstration States, thereby extending the demonstration period up to February 21, 2016.
  3. The structure of this overview is similar but not identical to the five categories defined in the original legislation and grant solicitation. A description of these categories may be found at
  4. To obtain these products, see
  5. The Child Core Set includes a wide range of topics, such as access to primary care, preventive care, maternal and perinatal health, behavioral health, care of acute and chronic conditions, oral health care, and family experiences with care. For more information on the Child Core Set, visit
  6. Alaska, Florida, Illinois, Maine, Massachusetts, North Carolina, Oregon, Pennsylvania, South Carolina, and West Virginia.
  7. Alaska, Colorado, Florida, Idaho, Illinois, Maine, Massachusetts, New Mexico, North Carolina, Oregon, South Carolina, Utah, Vermont, and West Virginia.
  8. As part of their final operational plans, demonstration States were required to show how their health IT activities would be coordinated with Federal grant programs authorized under or related to the Health Information Technology for Economic and Clinical Health Act (HITECH). Such programs included the CMS Medicaid transformation grants, the Regional Extension Centers, the Beacon Program, the meaningful use initiative, and other efforts overseen by the Office of the National Coordinator (ONC).
  9. Alaska, Florida, Idaho, Illinois, Maine, Oregon, Pennsylvania, South Carolina, Utah, Vermont, West Virginia, and Wyoming had projects that explicitly involved health IT; Colorado and New Mexico worked on health IT as part of other demonstration projects.
  10. Two grants involved three-State partnerships: Oregon-Alaska-West Virginia and Maryland-Georgia-Wyoming. Four grants involved two-State partnerships: Utah-Idaho, Florida-Illinois, Maine-Vermont, and Colorado-New Mexico.
Page last reviewed September 2015
Page originally created September 2015
Internet Citation: In conclusion. Content last reviewed September 2015. Agency for Healthcare Research and Quality, Rockville, MD.
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