After The Demonstration: What States Sustained After the End of Federal Grants to Improve Children’s Health Care Quality
| Autor: | Kelly Devers, Rachel Burton, Grace Anglin, Cindy Brach, Henry T. Ireys |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Quality Assurance Health Care Epidemiology media_common.quotation_subject Child Health Services Child Welfare Children's Health Insurance Program Article 03 medical and health sciences 0302 clinical medicine Environmental health Health care Humans Medicine Quality (business) 030212 general & internal medicine Child media_common Government Medicaid business.industry 030503 health policy & services Public health Child Health Public Health Environmental and Occupational Health Obstetrics and Gynecology Public relations United States Intellectual capital Child Preschool Pediatrics Perinatology and Child Health Sustainability 0305 other medical science business Health care quality |
| Zdroj: | Maternal and Child Health Journal. 22:195-203 |
| ISSN: | 1573-6628 1092-7875 |
| Popis: | Introduction Under the CHIPRA Quality Demonstration Grant Program, CMS awarded $100 million through 10 grants that 18 state Medicaid agencies implemented between 2010 and 2015. The program's legislatively-mandated purpose was to evaluate promising ideas for improving the quality of children's health care provided through Medicaid and CHIP. As part of the program's multifaceted evaluation, this study examined the extent to which states sustained key program activities after the demonstration ended. Methods We identified 115 potentially sustainable elements within states' CHIPRA demonstrations and analyzed data from grantee reports and key informant interviews to assess sustainment outcomes and key influential factors. We also assessed sustainment of the projects' intellectual capital. Results 56% of potentially sustainable elements were sustained. Sustainment varied by topic area: Elements related to quality measure reporting and practice facilitation were more likely to be sustained than others, such as parent advisors. Broad contextual factors, the state's Medicaid environment, implementation partners' resources, and characteristics of the demonstration itself all shaped sustainment outcomes. Discussion Assessing sustainment of key elements of states' CHIPRA quality demonstration projects provides insight into the fates of the "promising ideas" that the grant program was designed to examine. As a result of the federal government's investment in this grant program, many demonstration states are in a strong position to extend and spread specific strategies for improving the quality of care for children in Medicaid and CHIP. Our findings provide insights for policymakers and providers working to improve the quality of health care for low income children. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink