Health Services Access, Quality, and Financing

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

Improving Health Outcomes for Children (IHOC) First STEPS Phase I Initiative: Improving Immunizations for Children and Adolescents

Abstract: 

This report, co-authored by Kimberley Fox and Carolyn Gray, provides a final evaluation of the initial phase of First STEPS (Strengthening Together Early Preventive Services), a learning collaborative led by Maine Quality Counts to support 24 pediatric and family practices in improving their childhood immunization rates. The evaluation found that all participating practices had higher immunization rates after participating in First STEPS. On average, overall child immunization rates increased by 5.1% at 12 months and 7.1% at 15 months, and average immunization rates across practices increased significantly from 74.2% to 81.3%. Practices also reported significant improvement in the use of recommended office practices, including staff training, recall/reminder procedures, and the use of data/registries.

This work was conducted under a Cooperative Agreement between the Maine Department of Health and Human Services and the Muskie School of Public Service at the University of Southern Maine and is funded under grant CFDA 93.767 from the U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services (CMS) authorized by Section 401(d) of the Child Health Insurance Program Reauthorization Act (CHIPRA). These contents do not necessarily represent the policy of the U.S. Department of Health and Human Services, and you should not assume endorsement by the Federal Government.

Suggested citation: Fox K, Gray C. Improving Health Outcomes for Children (IHOC) First STEPS Phase I Initiative: Improving Immunizations for Children and Adolescents. (Final Evaluation Report).  Portland, ME: University fof Southern Maine, Muskie School of Public Service; March 2013.

Publication Type: 
Report
Publish Date: 
March 29, 2013
URL: 
http://www.maine.gov/dhhs/oms/pdfs_doc/ihoc/first-steps-phase1-eval-report.pdf

Examining MaineCare’s Coverage Options Under the Affordable Care Act

Abstract: 

This Brief was prepared by Erika Ziller and Trish Riley of the Muskie School of Public Service to inform an April 8, 2013 colloquium convened to explore options and implications of the Affordable Care Act (ACA) for Maine.

Highlights: In addition to increased Medicaid funding, in January 2014, the ACA will provide federally subsidized health care coverage for individuals with incomes up to 400% for Medicaid in a state, coverage will be subsidized by federally funded tax credits through health insurance exchanges, now known as the “Marketplace.” Those under 100% FPL are not eligible for Marketplace subsidies but could be eligible for Medicaid, depending upon state decisions.

Even if Maine does not choose to cover all those newly eligible under the ACA, beginning in 2014, MaineCare must extend eligibility for children aging out of foster care until they are 26, regardless of income. An estimated 46,000 uninsured individuals, nearly all of whom will be adults without children, would be newly eligible for Medicaid should Maine decide to participate in the ACA optional Medicaid coverage.

If Maine chooses not to participate in the ACA optional Medicaid program, the 14,000 uninsured childless adults with incomes between 100% and 138% FPL referenced above would be eligible to participate in subsidized coverage through the federal Marketplace, although there is disagreement over the affordability of these plans for this group. The 32,000 uninsured childless adults with incomes below 100% FPL would be ineligible for any subsidy through the Marketplace.

Continued coverage for currently eligible populations in Maine is uncertain. Maine must comply with a significant number of ACA provisions related MaineCare. These new requirements must be in place in all states, whether or not states extend eligibility in the Medicaid program or operate a health insurance Marketplace.

Publication Type: 
Research and Policy Brief
Publish Date: 
March 20, 2013
Author: 
URL: 
http://muskie.usm.maine.edu/Publications/HealthPolicy/Brief-Examining-MaineCares-Coverage-Options-Under-the-Affordable-Care-Act.pdf

Federal Health Care Reform: An Overview [Policy Brief]

Abstract: 

This policy brief discusses three of the main components of the Patient Protection and Affordable Care Act (ACA), also known as "Obamacare".  These components are helath insurance coverage, delivery system improvement, and cost containment.  The policy brief highlights some of the provision of the law that have already been implemented and those where importnat implementation decisions will have to be made.  The brief is authored by Dr. Andrew Coburn, PhD, Professor of Public Health and Director of the Population Health and Health Policy program at the USM Muskie School, and was presented at the Maine Policy Leaders Academy Health Care Forum breakfast session, Feb. 26, 2013 at the Senator Inn in Augusta,sponsored by the Maine Health Access Foundation.

For more information, please direct questions and comments to andyc@usm.maine.edu

Publication Type: 
Research and Policy Brief
Publish Date: 
February 26, 2013
Author: 
URL: 
http://muskie.usm.maine.edu/Publications/PHHP/Federal-Health-Care-Reform-Overview2013.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: 
8 003

Rural Implementation and Impact of Medicaid Expansions

Duration: 
7/1/2012 - 6/30/2013
Director: 
Erika Ziller
Principal Investigator: 
Andrew Coburn
Erika Ziller
Research Staff: 
Andrew Coburn
Erika Ziller
Jennifer Dunbar Lenardson, M.H.S.
Zachariah Croll
Abstract: 

A project funded by State Health Access Reform Evaluation (SHARE) to inform federal and state implementation of the Medicaid expansions under the ACA by estimating the size and characteristics of rural residents likely to be newly eligible. The study will provide nationally representative information that identifies the extent to which rural residents live in states that have already expanded coverage to low-income adults; how many eligible individuals have participated; the characteristics of the remaining pool of the rural uninsured; and the potential impact of Medicaid expansions on rural primary care and delivery system capacity.

Start Date: 
Sun, 2012-07-01
End Date: 
Sun, 2013-06-30
Legacy Muskie ID: 
0

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