CHIPRA Library

CHIPRA Library

Welcome to HMA’s CHIPRA Library for Florida and Illinois. Below that, you’ll find an explanation of each of the key federal priority areas:

These are followed by links to the pertinent documents in each area. A brief description of each document is also included.

Building on the CHIPRA Grant Experience to Spread and Sustain Quality Health Care for Children: Key Focus Areas and Sustainability Opportunities of the Florida-Illinois CHIPRA Quality Demonstration Grant

This report describes opportunities for how federal and state government, public and private payers, providers, advocates and other stakeholders can build on critical areas of the CHIPRA Quality Demonstration Grant’s success in the identified focus areas.

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Utilizing Quality Measures

In each year of the grant, Florida and Illinois engaged in the measurement and reporting of the federally selected Core Set of Children’s Health Care Quality Measures for Medicaid and CHIP. Florida and Illinois also jointly developed an assessment tool to identify which measures should be targeted for quality improvement, assisting the states in determining how to allocate limited state resources toward the opportunities where performance improvement efforts could have the greatest impact.

Pediatric Performance Measurement in Florida’s CHIPRA Demonstration Grant 2011

Florida’s CHIPRA data reports report on the CHIPRA core set measures. The reports include comprehensive analyses of each measure, the populations included, deviations from specifications were applicable, and display results by program type and funding source. Where available, these reports also included benchmark percentiles.

Performance Measurement Report 2011

Performance Measurement Report 2012

Performance Measurement Report 2013

Performance Measurement Report 2014

CHIPRA Core Set of Children’s Health Care Quality Measures for Medicaid and CHIP: Illinois’ Performance, Calendar Years 2009-2013

Illinois releases data books annually to report on the CHIPRA core set measures. In addition to the Medicaid (Title XIX) and CHIP (Title XXI) populations reported to the federal government, the data books also include the population of children who are state-funded (neither Title XIX nor Title XXI). Measures are reported to show trends and are compared to HEDIS percentiles, where available. The data books include a dashboard, a description of each measure and its relevance, as well as technical notes and analysis of each measure.

Calendar Years 2009-2011

Calendar Years 2009-2012

Calendar Years 2009-2013

Issue Brief: Moving Beyond CHIPRA Reporting: The Creation of an Assessment Tool to Analyze Opportunities for Improvement

This issue brief describes the assessment tool to analyze opportunities for improvement. The tool’s primary purpose is to assist Florida and Illinois in determining how to allocate limited state resources toward the opportunities where performance improvement efforts could have the greatest impact. The tool uses objective strategies for determining where the greatest opportunities are.

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Illinois Commentary: A CHIPRA Quality Demonstration Grantee’s Perspective on the Child Core Measure Set and Quality Measurement

Through the CHIPRA Quality Demonstration Grant, Illinois representatives were invited to participate in the Agency for Healthcare Research and Quality’s (AHRQ) Pediatric Quality Measures Program (PQMP). AHRQ and the PQMP Centers of Excellence authored a series of articles that were published as supplements to the Academic Pediatrics journal. This commentary provides Illinois’ perspective on the core measure set, including Illinois’ experience reporting the core set, benefits of a national reporting system, past and future challenges, and opportunities to use measures for population health and quality improvement.

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Promoting the Use of HIT

The Florida CHIPRA team, in partnership with the state HIE staff, conducted two initiatives to promote the enrollment of child-serving providers in the state’s two predominant HIT services offered through the HIE—Direct Secure Messaging (DSM), which provides a way for health care professionals to securely send and receive HIPAA-compliant, encrypted transmissions of Protected Health Information via email, and Hybrid Patient Look-Up (PLU), which allows providers to query the medical records of participating health care organizations, including hospital networks, Regional Health Information networks, county health departments and other participants, providing access to individual patient clinical information.

Illinois’ two main HIT initiatives included the development of a Prenatal Minimum Electronic Data Set (PMEDS) to provide prenatal care treatment information to prenatal providers and delivering hospitals that can be accessed at the time a woman presents at the hospital for delivery, and providing primary care providers access to an expanded database of referral resources through the Illinois Department of Children and Family Services’ Statewide Provider Database (SPD).

AHIT Hybrid PLU Demonstration Presentation (February 20, 2015)

This presentation, presented to the Health Information Exchange Coordinating Committee, describes the Florida’s pilot project to enroll child-serving providers in one of the state’s HIE offerings: the Hybrid Patient Look-Up (PLU) service.

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Implementing and Evaluating Provider-Based Delivery Models

Pediatric medical home learning collaborative demonstrations were a significant endeavor of the CHIPRA grant in both Florida and Illinois, where technical assistance and learning collaboratives focused on medical home transformation were provided to child-serving providers. An additional medical home effort was a collaborative venture of both states to assist practices through the process of applying for National Committee for Quality Assurance (NCQA) Patient-Centered Medical Home (PCMH) recognition.

Florida Pediatric Medical Home Demonstration Project Evaluation 2011-2014

These papers comprise the results of The Institute for Child Health Policy (ICHP) at the University of Florida’s four-year, longitudinal, multi-stakeholder evaluation of Florida’s Medical Home Demonstration project led by the American Academy of Pediatrics (AAP).

Project Evaluation (2011)

Project Evaluation (2012)

Project Evaluation (2013)

Project Evaluaton (2014)

Cost and Cost Effectiveness of Pediatric Medical Home Transformation (December 16, 2014)

As part of Florida’s Medical Home Demonstration Project evaluation, this paper describes a cost effectiveness study to assess the cost to pediatric clinics in transforming to a pediatric medical home.

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Florida Pediatric Medical Home Demonstration Project

The AAP produced this promotional video about the Florida medical home project, featuring interviews with Florida CHIPRA project participants, including a parent partner, who highlighted the benefits of participating in the project and implementing a medical home as well as benefits of the medical home model for patients, families and healthcare providers.

Video Link

American Academy of Pediatrics: Medical Home Resources

This webpage of the AAP provides additional information related to their work on the Florida CHIPRA Grant Medical Home Demonstration Project.

Website Link

Illinois CHIPRA Medical Home Project Baseline Results on the National Committee for Quality Assurance Patient-Centered Medical Home Self-Assessment

This report discusses baseline results analyzed for Illinois CHIPRA practices that completed the NCQA self-assessment. The report contains two main sections: one that describes results across all 51 sites in Illinois and the other that summarizes results of a sub-set of those sites – those identified as a part of one of six different health systems (n=31).

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Illinois CHIPRA Medical Home Project Final Report on the National Committee for Quality Assurance Patient-Centered Medical Home Self-Assessment

This report discusses results of the post-assessment and the growth of participating practices: at baseline the practices’ mean score was 35 and was 78 post-program (of 100 points total). The report highlights the ways in which the demonstration project worked to build the foundational skills of the practice teams to implement medical home, improve clinical care, or improve quality improvement efforts that allow a practice to balance the needs of patient-centered care and effectively managing the practice.

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Recommendations on incentives to promote the voluntary adoption of medical home principles by HFS’ providers of primary care services to children: Position Paper

This paper discusses the growing emphasis on medical homes as a means to improve quality and lower costs. In the paper, the CHIPRA Medical Home Incentives Workgroup makes six recommendations for the Illinois Department of Healthcare and Family Services (HFS) to adopt in order to expand the availability of medical homes for children.

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Achieving NCQA PCMH Recognition: A toolkit for practices seeking to apply

A collaborative venture of Florida and Illinois sought to provide direct technical assistance to child-serving practices working to achieve NCQA Patient-Centered Medical Home (PCMH) recognition in an effort to gain a better understanding of the resources and effort necessary for practices to achieve PCMH recognition, identify transformation areas and processes that are the most challenging for individual practices, develop key resources/tools to share with future practices, and inform the medical community and federal and state policy makers of needed resources. The NCQA PCMH Recognition Toolkit was assembled to share more broadly with practices considering applying for recognition the tools created through this work.

Website Link

Final Report on the Illinois CHIPRA PCMH-Asthma Learning Collaborative

This report discusses the experience of fifteen primary care practices that participated in a 10-month learning collaborative to integrate PCMH principles, with a clinical focus on asthma. The report analyzes data from the practices over the course of the intervention and addresses successes, challenges, and sustainability.

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PCMH Transformation Resources – Change Packet

A variety of resources used in the PCMH-Asthma Learning Collaborative to help practices with transformation and spread.

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Assessing the Utility of Other Innovative Approaches to Enhance Quality

Improving the timely and appropriate use of perinatal care to improve health outcomes for Medicaid- and CHIP-enrolled children is a top priority for Florida and Illinois, and was thus the focus of their work in the federal key priority area to assess other innovative approaches to enhance child health care quality. Both states utilized CHIPRA resources to develop and/or support state Perinatal Quality Collaboratives (PQCs). Illinois also engaged in a number of other perinatal projects, including the development of a Prenatal Care Quality Tool (PCQT) to help prenatal providers deliver recommended content of prenatal care; development of the PMEDS tool described above, a Perinatal Education Toolkit to help clinical and community providers educate Medicaid women on the benefits and importance of preconception, prenatal, postpartum, and interconception care; a study to explore existing recommendations, perceptions of, barriers to and preferences for postpartum care, which included testing an alternative approach to postpartum contraceptive care; and the formulation of a perinatal care transitions workgroup to identify best practices and improve contractual language for health plan contracts related to care transitions.

Florida Perinatal Quality Collaborative Website

The Florida Perinatal Quality Collaborative’s (FPQC’s) mission is to advance perinatal health care quality and patient safety for all of Florida’s mothers and infants through the collaboration of all FPQC stakeholders in the development of joint quality improvement initiatives, the advancement of data-driven best practices and the promotion of education and training. CHIPRA funding allowed for the continuation and expansion of promising quality improvement projects.

Website Link

Evaluation Survey of Golden Hour Project Participants

This report documents findings of a survey to assess the effectiveness of, and the extent to which Florida’s Golden Hour Project facilitated hospitals’ ability to manage the delivery room during births of infants <31 weeks gestation or birth weight less than 1500 grams.

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CHIPRA Perinatal Education Toolkit Pilot Study Report

This report analyzes the results of pilot testing the Perinatal Education Toolkit in five provider sites in two geographic areas of Illinois and includes recommendations for future enhancements and spread of the educational materials.

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Perinatal Education Toolkit

The Toolkit is web-based and was designed to assist providers in educating patients about perinatal topics. It includes information addressing preconception, prenatal, postpartum, and interconception care. The materials are print-ready and allow an organizational logo to be added.

Website Link

Perinatal Education Toolkit Content and Uses

This document provides a description of each tool in the Perinatal Education Toolkit, format, and suggested uses.

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HFS Provider Notice: Postpartum Visits and Perinatal Care Transitions

This notice was disseminated to all enrolled HFS providers of perinatal care. It reviews postpartum policy and reimbursement and provides best practices for perinatal care transitions.

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Postpartum Visit and Contraception Study

This report details the results of a multi-part study undertaken by researchers at the University of Illinois, School of Public Health. The report identifies and summarizes the research related to what is known about the postpartum visit, strategies for increasing its use, as well as strategies for increasing uptake of postpartum contraception; summarizes women’s and providers’ perspectives on alternative approaches to the delivery of postpartum care and contraception; and, explores the role of the well-baby visit in the early postpartum period as a time for women to discuss reproductive life planning and family planning needs.

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Illinois Perinatal Quality Collaborative Website

The Illinois Perinatal Quality Collaborative (ILPQC) works to improve the health of pregnant women, mothers, and infants through perinatal quality improvement initiatives implemented by participating birthing hospitals across Illinois. ILPQC provides quality improvement infrastructure, resources, and data management support to over 100 hospitals across the state – helping to make Illinois an even better place to be born.

Website Link

Prenatal Care Quality Tool (PCQT)

This tool is a compilation of minimum prenatal care services based on American Congress of Obstetrics and Gynecology (ACOG) and American Academy of Family Physician (AAFP) guidelines. Information is organized by visit/trimester and includes clinical services, labs, education, and referrals. The tool can be used as a paper checklist or integrated into an electronic health record (EHR) to assure recommended prenatal care services are provided to women at the appropriate times.

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Supplemental Resources to the PCQT

Health Education Resource Matrix

The matrix is a supplemental tool that aligns with the prenatal and postpartum topics in the PCQT to support patient education. The matrix is a comprehensive electronic guide of educational resources and also includes preconception and interconception topics. The matrix also can be used by community and social service providers to educate women on perinatal and well-women topics and reinforce education received from medical providers. Using hyperlinks, the matrix provides access to free educational materials from national organizations such as the March of Dimes, with easy click and print capability. The materials can be used for one-on-one patient education or to supplement and reinforce verbal education. The matrix includes links to websites that can be used for patient self-education.

Website Link

High-Risk Referral Crosswalk

This is a reference tool that crosswalks guidance for high-risk referrals from ACOG with the Illinois Perinatal Code. The crosswalk provides information for providers to appropriately refer high-risk women for consultation or higher level care for issues related to reproductive history, active medical conditions, obstetrical complications, and psycho/social concerns.

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Other Resources

CHIPRA National Evaluation Website

The National Evaluation Team (NET) produced a series of issue briefs, called Evaluation Highlights, to share strategies, lessons learned and outcomes of the CHIPRA Quality Demonstration Grants, as well as present analysis and findings for various topics. Florida and/or Illinois are featured in five of the Evaluation Highlights.

  • Evaluation Highlight No. 2: How are States and evaluators measuring medical homeness in the CHIPRA Quality Demonstration Grant Program?
  • Evaluation Highlight No. 6: How are CHIPRA quality demonstration States working together to improve the quality of health care for children?
  • Evaluation Highlight No. 11: How are CHIPRA quality demonstration States using quality reports to drive health care improvements for children?
  • Evaluation Highlight No. 12: How are CHIPRA quality demonstration States improving perinatal care?
  • Evaluation Highlight No. 13: How did CHIPRA quality demonstration States employ learning collaboratives to improve children’s health care quality?

Website Link

AAP Quality Connections

The AAP Quality Connections Newsletter provides communication and updates on quality improvement programs and projects, including medical home.

Website Link

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