Vernon Smith, Jennifer N. Edwards, Esther Reagan, Dennis Roberts
V. Smith, J. Edwards, E. Reagan et al., Medicaid and CHIP Strategies for Improving Child Health, The Commonwealth Fund, July 2009.
Medicaid and the Children's Health Insurance Program (CHIP) are at a turning point in their efforts to improve the health and well-being of children and adolescents. In each state, program officials are working with existing national measurement systems or state-developed tools to assess health care quality, and they have developed sufficient baseline data to show where improvements are needed. They are trying out new strategies, and take pride in their efforts to improve health outcomes for children and adolescents.
At the same time, states would like to do better. They believe their quality goals would be achieved more quickly if they had access to specialized technical assistance that allows them to learn from experts and from the experience of colleagues in other states. With states ready to push forward, new federal funding to support the advancement of child quality measurement and improvement would come at an opportune time.
This study is based on findings from a national survey of Medicaid and CHIP programs as well as focused discussions with selected program officials. Conducted by Health Management Associates, the survey and discussions addressed current approaches being used by states to improve quality of care and health outcomes for children and adolescents, the barriers states experience as they pursue quality improvement activities, and their assessment of what resources or strategies would lead to further improvements. Three compelling messages emerged:
The Centers for Medicare and Medicaid Services, the Agency for Healthcare Research and Quality, and other organizations have an opportunity to accelerate the pace of change. Medicaid and CHIP officials indicated that the strategies they would value most would include targeted technical assistance, improved opportunities to learn from each other and from experts in quality improvement, and participation in an active coaching process that includes expert guidance to the states and to their health plan partners.