Health: Health Care Quality Management

Maine Pediatric and Family Practice Survey Chartbook

Abstract: 

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

Publication Type: 
Report
Publish Date: 
January 29, 2011
URL: 
http://www.maine.gov/dhhs/oms/pdfs_doc/children_IHOC/Provider%20Survey%20final.pdf

Early Lessons Learned in Implementing MaineCare Health Homes

Abstract: 

This Issue Brief, authored by researchers at the University of Southern Maine's Muskie School, highlights key lessons learned from the first year of implementation of the MaineCare Health Homes Initiative.

Key Findings:

  • MaineCare's Health Homes Initiative has expanded Maine's capacity for chronic care management in primary care practices and community care teams (CCTs);
  • CCTs provide valuable additional support to patients of Health Homes, including home visits and social supports in the community;
  • Flexibility in program design allowed for wide variation of service delivery models within CCTs;
  • Three percent of Health Home members were referred to CCTs by the end of the first year, but overall practice referral rates varied by CCT--from 1% to 7% of Health Home members within their associated practices.

To view or download the full study, click here

To view or download the Issue Brief on enrollment in the first year of MaineCare Health Homes implementation, click here

Suggested Citation: Fox K, Gray C, Rosingana K. Early Lessons Learned in Implementing MaineCare Health Homes. Portland, ME: University of Southern Maine, Muskie School of Public Service; September, 2014.

Publication Type: 
Research and Policy Brief
Publish Date: 
September 30, 2014
URL: 
http://muskie.usm.maine.edu/Publications/PHHP/MaineCare-HealthHomes-Implementation.pdf

Safety of Rural Nursing Home-to-Emergency Department Transfers: Improving Communication and Patient Information Sharing across Settings

Abstract: 

This article was published in the January/February 2015 issue of the Journal for Healthcare Quality, and reports on the evaluation of a demonstration in 10 rural communities to improve the safety of nursing facility (NF) transfers to hospital emergency departments by forming interprofessional teams of hospital, emergency medical service, and NF staff to develop and implement tools and protocols for standardizing critical interfacility communication pathways and information sharing. The research team at the USM Muskie School worked with each of the 10 interprofessional teams to document current communication processes and information sharing tools and to design, implement and evaluate strategies/tools to increase effective communication and sharing of patient information across settings.

For more information on this study, please contact Judy Tupper.

Suggested citation: Tupper JB, Gray CE, Pearson KB, Coburn AF. Safety of Rural Nursing Home-to-Emergency Department Transfers: Improving Communication and Patient Information Sharing across Settings. J Healthc Qual. 2015;37(1):55-65.

Publication Type: 
Journal Article
Publish Date: 
January 13, 2015
Project: 

Understanding Changes to Physician Practice Arrangements in Maine and New Hampshire

Abstract: 

This report examines trends in the organization and ownership of physician practices in Maine and New Hampshire. The Maine Office of MaineCare Services and the New Hampshire Office of Medicaid Business and Policy observed a trend in the conversion of physicians from private practice to other practice arrangements including Rural Health Clinics (RHCs), Federally Qualified Health Centers (FQHCs), hospital-owned practices, and hospital outpatient departments. Faced with increased costs for care provided within these facilities, both Medicaid programs sought to understand more about these changes, including their magnitude, the forces driving them, and their short and longer-term implications.

Suggested Citation:

Lenardson J, McGuire C, Alfreds S, et al.  Understanding Changes to Physician Practice Arrangements in Maine and New Hampshire. Portland, ME: University of Southern Maine, Muskie School of Public Service, Institute for Health Policy; January 2008.

Publication Type: 
Report
Publish Date: 
January 31, 2008
URL: 
http://muskie.usm.maine.edu/Publications/ihp/PhysicanPracticeChanges.pdf

Improving Health Outcomes for Children (IHOC): Summary of pediatric quality measures for children enrolled in MaineCare FFY 2009 - FFY 2012

Abstract: 

This report, authored by USM Muskie School research staff, presents the results of the 16 CHIPRA Core Measures that were collected using MaineCare claims or Vital Statistics data and reported in the State of Maine’s FFY 2012 CHIP Annual Report to the Centers for Medicare and Medicaid Services (CMS). Also included in this report are an additional three measures from the Improving Health Outcomes for Children (IHOC) project’s Master List of Pediatric Measures. In addition to presenting results in graphs and narrative, this report also provides measure definitions and background information about each measure topic.

The goal of this document is to present the claims- and vital statistics-based CHIPRA and IHOC measure results in a user-friendly format for IHOC project stakeholders. Measures are grouped by topic. For each topic, a Background section provides a brief description and rationale for collection. (The background discussion for CHIPRA Core Measures is drawn from the Background Report for the Initial, Recommended Core Set of Children’s Healthcare Quality Measures for Voluntary Use by Medicaid and CHIP Programs. Available at: http://www.ahrq.gov/chipra/corebackgrnd.htm) Next, we provide a general description of how each measure is defined, followed by the results.

Suggested citation: Anderson N, Meagher T. Improving Health Outcomes for Children (IHOC): Summary of Pediatric Quality Measures for Children Enrolled in MaineCare FFY 2009 - FFY 2012.   Portland, ME: University of Southern Maine, Muskie School of Public Service; April 2013.

Publication Type: 
Report
Publish Date: 
April 30, 2013
URL: 
http://www.maine.gov/dhhs/oms/pdfs_doc/ihoc/Summary_of_Pediatric_Quality_Measures_2012.pdf

Behavioral Risk Factor Surveillance System (BRFSS) Data Management & Analysis 2012-2013

Duration: 
10/1/2012 - 9/30/2013
Collaborators: 
Maine CDC
Abstract: 

Behavioral Risk Factor Surveillance System is one of Maine’s standard health behavior surveillance systems, data from which informs policy development, program planning, and other public health interventions for chronic disease prevention. This project will assist the Maine BRFSS coordinator and the Maine CDC to achieve BRFSS objectives. Muskie School staff will update the BRFSS interactive web query as well as maintain multiple-year standardized datasets, add the most recent year of data, and update documentation. Muskie staff will also perform other analyses as necessary, including multivariate and trend analyses to help the Maine CDC better understand prevalence, risk factors and disease management for health behaviors and conditions (such as diabetes, asthma, and cardiovascular disease) that impose a heavy burden on the residents of Maine and its health care system.

Start Date: 
Mon, 2012-10-01
End Date: 
Mon, 2013-09-30
Legacy Muskie ID: 
8003

Maine Rural Health Research Center 2012

Duration: 
9/1/2012 - 8/31/2013
Director: 
David Hartley
Principal Investigator: 
Erika Ziller
Research Staff: 
Andrew Coburn
Anush Yousefian Hansen
David Lambert
Donna Reed
Erika Ziller
Jennifer Dunbar Lenardson, M.H.S.
John Gale
Karen Pearson
Zachariah Croll
Abstract: 

Established in 1992, the mission of the Maine Rural Health Research Center is to inform health care policy making and the delivery of rural health services through high quality, policy-relevant research, policy analysis and technical assistance on rural health issues of regional and national significance. The Center's core funding is provided by the federal Office of Rural Health Policy.

Project URL: 
http://muskie.usm.maine.edu/ihp/ruralhealth/
Start Date: 
Sat, 2012-09-01
End Date: 
Sat, 2013-08-31
Legacy Muskie ID: 
8071

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