Transcript Slide 1

MARCHING TO THE BEAT OF
A DIFFERENT DRUM
Two States Experience Using the
CHIPRA Quality Grant and ABCD
To Test and Evaluate Promising Ideas
To Improve the Quality of Children’s Health Care
NASHP’s 23rd Annual State Health Policy Conference
October 5, 2010
Charles A. Gallia, PhD, Manager Research and Analysis
Oregon Department of Human Services
Felicity Costin Myers, Ph.D., Deputy Director of Medical Services
South Carolina Department of Health and Human
Background
To better understand the session, we need to look at two
programs that were leaders pre-health reform
These programs were designed to empower states to develop
new models of coordination and linkages for children’s health
(Medicaid and CHIP) post EPSDT
Assuring Better Child Health and Development (ABCD)
The Children's Health Insurance Program Reauthorization
Act of 2009 (CHIPRA)
ABCD
 The Assuring Better Child Health and Development (ABCD) Program is
funded by the Commonwealth Fund, administered by NASHP, and was
designed to assist states in improving the delivery of early child
development services for low-income children and their families by
strengthening primary health care services and systems that support
the healthy development of young children, ages 0-3
 The first ABCD Consortium (ABCD I) was created in 2000 and provided 3
year grants to four states to develop or expand service delivery and
financing strategies aimed at enhancing healthy child development
 The ABCD II Initiative was a 4 year initiative launched in 2003 designed
to assist 5 states in building the capacity of Medicaid programs to
deliver care that supports children’s healthy mental development
ABCD
 The ABCD Screening Academy began in April 2007 and
provided technical assistance to 21 states/territories to
increase use of an AAP general developmental screening
tool as a part of health supervision during well-child care
provided by primary care providers who act as young
children’s medical homes
 ABCD lll, which began in October 2009, will work with 5
states to develop and test sustainable models for improving
care coordination and linkages between pediatric primary
care providers and other providers who support children's
healthy development
CHIPRA
 The Children's Health Insurance Program Reauthorization
Act of 2009 (CHIPRA) was created to improve access to and
the quality of care provided to children.
 In particular, Title IV of CHIPRA creates a broad quality
mandate for children's health care and authorizes child
health care quality initiatives for both the CHIP and
Medicaid programs.
 CHIPRA provided award of grants to evaluate promising
ideas for improving the quality of children's health care
CHIPRA
 On February 22, 2010, the Centers for Medicare & Medicaid
Services awarded a total of $20 million in first-year CHIPRA
Quality Demonstration Grant funds to 10 states:
Colorado (New Mexico), Florida (Illinois), Maine (Vermont),
Maryland (Georgia and Wyoming), Massachusetts, North
Carolina, Oregon (Alaska and West Virginia), Pennsylvania,
South Carolina, and Utah (Idaho)
 Eight of the 10 grantees will test a recommended set of child
health quality measures, seven of the ten states will use the
funds to implement health information technology (HIT)
strategies, and two states specifically plan to test a new pediatric
electronic health record format being developed under CHIPRA
CHIPRA Awardee Projects
 Colorado and New Mexico will form an Interstate Alliance of School-Based Health Centers
(SBHCs) to integrate school-based health care into a medical home approach to improve
the health care of underserved school-aged children and adolescents.
 Florida, in partnership with the State of Illinois will test collection and reporting of
recommended and selected supplemental measures of children’s health quality, using
existing data sources and improved data sharing. Florida and Illinois will also work to
support collaborative quality improvement projects to improve birth outcomes across the
two States .
 State of Maryland, in partnership with Georgia and Wyoming will implement and/or
expand a Care Management Entity (CME) provider model to improve the quality and
better control the cost of care for children with serious behavioral health challenges who
are enrolled in Medicaid or the Children’s Health Insurance Program.
 Pennsylvania will partner with several medical centers and hospitals to test and report on
recommended pediatric quality measures and promote the use of health information
technology in health care delivery to maximize the early identification of children with
developmental delay, behavioral health issues, and those with complex medical
conditions.
Conversation with Two States
Today we are going to have a conversation with two states that are looking
at these initiatives in two unique ways
 Oregon
an ABCD state and also a CHIPRA awardee - they developed a
partnership with Alaska and West Virginia to develop and validate
quality measures, improve infrastructure for electronic or personal
health records utilizing health information exchanges, and
implement and evaluate medical home and care coordination
models
 South Carolina
a CHIPRA awardee - they plan to build a quality improvement
infrastructure that enhances the ability of 15 of the State’s pediatric
primary care practices to establish medical homes that effectively
coordinate and integrate physical and mental health services and
where health information technology will be used to gather,
aggregate, and report on outcomes