Comparison of Primary Care Received by New Hampshire Medicaid Members at Different Practice Settings, 2006

This study was conducted under a sub-contract between the Maine Health Information Center (MHIC) and the Muskie School of Public Service at the University of Southern Maine. This subcontract is part of a larger contract between the MHIC and the State of New Hampshire Department of Health and Human Services, Office of Medicaid Business and Policy, titled New Hampshire Comprehensive Health Care Information System. The views expressed are those of the authors and do not necessarily represent the views of the MHIC, New Hampshire DHHS, or the University of Southern Maine

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

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

First STEPS Phase I Initiative: Improving Immunizations for Children and Adolescents

This evalution report, authored by research staff at the USM Muskie School, assesses the change in immunization rates in participating pediatric and family practices that serve a high volume of children insured by MaineCare (Maine\u27s Medicaid system). The authors also summarize lessons learned in implementing changes in practices and challenges in using the immunization measures at the practice-level to inform quality improvement

First STEPS Phase III Initiative: Improving Oral Health and Healthy Weight in Children Final Evaluation Report

This report summarizes evaluation findings from Phase III and assesses change in oral health and healthy weight screening rates, referrals and related office system procedures in participating practices. The report also highlights challenges encountered and lessons learned in implementing changes to office systems, in responding to state policy changes, and in collecting and tracking oral health and healthy weight measures at the practice-level to inform quality improvement

First STEPS Phase II Initiative: Improving Developmental, Autism, and Lead Screening for Children

First STEPS (Strengthening Together Early Preventive Services) is a learning initiative supported by Maine\u27s CHIPRA quality demonstration grant to support measure-driven practice improvement in pediatric and family practices across the state on improving developmental, autism, and lead screening for children. This report, authored by research staff at the USM Muskie School, evaluates the impact of Phase II of Maine\u27s First STEPS initiative, which was implemented from May to December 2012 and included 12 practices serving more than 20,000 children on MaineCare (Maine\u27s Medicaid system). The authors assess changes in developmental, autism, and lead screening rates and evidence-based office processes in participating practices before and after the initiative, as well as related systems changes. They also summarize lessons learned in implementing changes in practices and challenges in using CHIPRA and IHOC developmental, autism, and lead screening measures at the practice-level to inform quality improvement

Achieving Consensus on Measure-Driven Child Health Quality: Maine’s Improving Health Outcomes for Children Initiative

This brief describes Maine’s process for selecting child health quality measures, including identified strengths and limitations of the CHIPRA core measures that led to the inclusion of additional state-specific measures and the factors considered for selection. Subsequent articles will describe how measures have been implemented and used to improve child health quality and how they have been integrated into systems of care (e.g. health information technology systems, policy changes)

Maine Pediatric and Family Practice Survey Chartbook: Improving Health Outcomes for Children

As part of the IHOC initiative, the Muskie School of Public Service at 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 will be 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. This report summarizes the results of the initial survey and assesses quality improvement activities in pediatric and family practices at baseline

Early Lessons Learned in Implementing MaineCare Health Homes

The MaineCare Health Homes Initiative is designed to improve care coordination for MaineCare members with complex chronic medical conditions. The initiative, which began in January 2013, builds off the State’s existing multi-payer Patient Centered Medical Home (PCMH) Pilot project and Medicare Advanced Primary Care Practice (MAPCP) Demonstration by providing add-on payments to primary care practices to provide “whole person” integrated care coordination for MaineCare members with specific chronic conditions. For the highest need patients, practices work with Community Care Teams (CCT) that provide short-term care management and social support services. The Muskie School of Public Service is evaluating the implementation of this new care model. This issue brief highlights key lessons learned from the first year of implementing Health Homes. A separate issue brief describing MaineCare members enrolled in the first year can be found at http://digitalcommons.usm.maine.edu/healthpolicy/1