In February 2010, Maine and Vermont were awarded a five-year demonstration grant from the Centers for Medicare and Medicaid Services to improve care quality for children who are insured by Medicaid and the Children’s Health Insurance Program (CHIP). In Maine, Improving Health Outcomes for Children (IHOC) is a public/private collaboration of health systems, pediatric and family practices, associations, state programs and consumers that is intended to 1) select and promote a set of child health quality measures; 2) build a health information technology infrastructure to support the reporting and use of quality information; and 3) transform the delivery of health services for children using a patient centered medical home model.
As part of the 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 healthcare quality. The purpose of the survey is to provide baseline information about quality improvement activities in primary care practices serving children in Maine. Survey data was used to inform IHOC activities and to monitor changes over time. 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% responded. Responding practices represent more than one-quarter of family practices and nearly two thirds of all pediatric practices in the state. Together these practices served more than half (57%) of all children insured by MaineCare, or nearly 68,000 MaineCare children. Respondents represent a broad distribution of practices across regions of the state and practice size and ownership, and include nearly two-thirds of practices participating in IHOC’s First STEPS learning collaborative.
This report summarizes the results of the initial survey and assesses quality improvement activities in pediatric and family practices at baseline. In 2014, a follow-up survey will be conducted to assess how quality improvement has changed in child-serving practices statewide over time and within specific types of practices (e.g. those participating in First STEPS).
Key issues from the baseline survey results include the following:
- Medical Home Recognition and Practice-Level Quality Improvement
- Data Systems Used to Track and Monitor Care
- Use of Electronic Health Records for Quality Improvement
- Awareness and Use of Financial Incentives and Data for Quality Improvement from Payers
A follow-up survey was fielded during the final year of the initiative in 2014.The practice survey was designed to assess changes in knowledge and awareness of: child health quality measures; evidence-based clinical guidelines; recommended preventive screening tools; office systems and procedures; and the degree to which Maine practices use standardized protocols to monitor and improve children’s healthcare quality. Results of that survey can be viewed or downloaded here: Child Health Quality in Maine: Practice Survey Report 2011-2014