State at a Glance: Maine
National Evaluation of the CHIPRA Quality Demonstration Grant Program
Maine is featured in the following reports from the National Evaluation:
- Evaluation Highlight No. 1: How are CHIPRA demonstration States approaching practice-level quality measurement and what are they learning?
- Evaluation Highlight No. 2: How are States and evaluators measuring medical homeness in the CHIPRA Quality Demonstration Grant Program?
- Evaluation Highlight No. 4: How the CHIPRA quality demonstration elevated children on State health policy agendas
- Evaluation Highlight No. 6: How are CHIPRA quality demonstration States working together to improve the quality of health care for children?
- Evaluation Highlight 11: How are CHIPRA quality demonstration States using quality reports to drive health care improvements for children?
- Evaluation Highlight No. 13: How did CHIPRA quality demonstration States employ learning collaboratives to improve children’s health care quality?
- Article: Nine States’ Use of Collaboratives to Improve Children’s Health Care Quality in Medicaid and CHIP
Learn more about Maine's CHIPRA quality demonstration projects on this page:
Overview
As one of the 10 grantees, Maine is working with Vermont in a two-State partnership to implement projects in three of the five grant categories:
- Showing how a core set of children's quality measures can be used to improve quality of care for children.
- Promoting the use of health information technology (IT) to enhance service quality and care coordination.
- Implementing a more comprehensive provider-based model of service delivery.
Maine's Objectives
Maine is working to improve the reporting and use of children's quality measures. The State, for example, is testing the collection and reporting of the measures using clinical data from electronic health records (EHRs), Maine's health information exchange (HIE), and Maine's immunization registry. Maine also has a health IT project to develop and implement an electronic comprehensive health assessment (CHA) for children in the State's foster care system. In addition, Maine will extend current statewide efforts to promote medical homes by enhancing access to child-specific learning collaboratives for selected pediatric and child-serving practices.
Working with the Initial Core Set of Children's Quality Measures
Maine's goal is to expand the State's current quality performance measurement and incentive payment systems to include children's quality measures. By including these measures, Maine hopes to reduce unnecessary variation in pediatric care, align payment and financial incentives with these measures, and improve child heath. The State will focus on a range of measures including the initial core set of children's quality measures and EPSDT Bright Futures preventive measures.
Using Health IT to Improve Child Health Care Quality
Maine is using health IT to improve measure reporting. The State is using data from electronic medical records and Maine’s HIE to collect and report on the core set of children’s quality measures and other quality measures. In addition, the State is enhancing the Maine immunization registry to allow for practice-level reporting of core measures and other immunization measures.
Maine is also using health IT to pilot the automation of the CHA for children in Maine's foster care system. Before automating the CHA, the State is tracking and improving office workflows. The electronic CHA will include secure document exchange and storage of CHA information so that it is available to key health and social service providers with secure access and authorization.
Assessing a Provider-Based Model of Care
Maine is building on the State's ongoing patient-centered medical home (PCMH) pilot program that began before the CHIPRA quality demonstration. It involves 22 adult and four pediatric practices, all of which are participating in a learning collaborative focused on medical homes. The CHIPRA quality demonstration provides additional pediatric-specific learning sessions for the pediatric PCMH pilot practices and additional family medicine practices that serve a high-volume of children covered by Maine’s Medicaid and CHIP program. The State also is providing these practices tools to support integrating Bright Futures screening information into their EHRs and helping them develop and track a standardized list of quality measures.
Evaluation Questions
The national evaluation team will gather information from Maine to address a wide range of questions about the implementation and outcomes of their efforts including:
- How has standardizing pediatric quality measures affected provider operations and performance?
- How did Maine integrate data on EPSDT services into pediatric EHRs?
- To what extent were Maine's efforts to enhance the child focus of its ongoing medical home project successful in improving the quality of health care for children?
- What are the key lessons from Maine's experience that would be useful for other States?
Additional Resources
Maine provided the following reports and other resources:
Maine Pediatric and Family Practice Survey Chartbook
This report summarizes baseline survey results for more than one-quarter of family practices and nearly two-thirds of all pediatric practices in Maine about how they use data, clinical guidelines, and office systems to monitor and improve children’s health care quality.
Maine Improving Health Outcomes for Children (IHOC) Bright Futures As-Is Assessment
This report summarizes the findings of a study of how Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) and other clinical data are currently entered, used, and exchanged electronically through information systems at selected pediatric practices and health systems, the State of Maine, and the State’s health information exchange.
This report presents the results of 17 of the CHIPRA Core Measures collected using MaineCare claims or Vital Statistics data and results from the additional child health measures from the IHOC Master List of Pediatric Measures that are not CHIPRA measures for 2009-2012.
Improving Health Outcomes for Children (IHOC) First STEPS Initiative Final Evaluation Reports
Phase I: Improving Immunizations for Children and Adolescents
Phase II: Improving Developmental, Autism, and Lead Screening for Children
These reports evaluate First STEPS (Strengthening Together Early Preventive Services), an initiative to support measure-driven practice improvement in pediatric and family practices across the State.
Note: These reports have been submitted by the CHIPRA Quality Demonstration States and are made available on this Web site as a courtesy. The description of any product, policy, program, or other resource on this Web site does not imply an endorsement by AHRQ, the U.S. Department of Health and Human Services (HHS), or any other Government agency.
Learn More
This information is current as of February 2014, slightly more than 4 years after the grant award. To learn more about the projects that Maine is implementing under the CHIPRA Quality Demonstration Grant Program, please contact:
Joanie Klayman, LCSW, CHIPRA Project Director
Cutler Institute for Health and Social Policy
Muskie School of Public Service, University of Southern Maine
P.O. Box 9300, Portland, Maine 04104-9300
207-780-4202
jklayman@usm.maine.edu
