Table 1.

CHIPRA Quality Demonstration Grant Program: categories, goals, and examples

Grant category (number of states with projects)	CMS’s specific goals	Example project (state) and associated elements
A Report and use quality measures for children, including the CMS child core set (10 states)	Demonstrate collection and reporting on core set of child quality measures Learn how best to collect data for measures and overcome barriers Learn how stakeholders use quality measures Measure impact of use of core measures	Report and foster improvement on quality measures (Alaska) Elements Fielded Consumer Assessment of Healthcare Providers and Systems survey in 3 practices in preparation for reporting patient experience measure Hired data analyst to address obstacles to reporting child core set measures from Medicaid administrative data Engaged Medicaid and public health staff to monitor performance on measures and develop QI strategies
B Develop or enhance HIT, such as electronic health records (EHRs) and health information exchange (HIE) (12 states)	Learn how best to implement HIT, including HIT promotion and how barriers can be overcome Learn how to use HIT data for quality improvement and cost reduction Measure impact of HIT on children’s health care quality Determine if and how HIT increases transparency and consumer choice	Use HIT to improve information exchange and care coordination (Utah) Elements Laid groundwork for interstate HIE and shared immunization data with Idaho Developed and tested portal for pediatric medical record Enhanced online resources to help physicians and parents care for children with special health care needs Developed and implemented electronic platform that practices use to share information about quality improvement work
C Develop or expand provider-based care models, such as PCMHs, SBHCs, or CMEs (17 states)	Demonstrate that selected model can be implemented Learn how best to implement models of care and identify how barriers can be overcome Determine impact of selected model	Help 18 child-serving practices improve quality of care (South Carolina) Elements Provided practice facilitation (one-on-one technical assistance) Held 8 learning collaboratives Provided maintenance-of-certification credit to physicians Funded parent involvement in quality improvement work Hosted training on integration of primary and behavioral health care
D Implement and evaluate the impact of a model EHR format for childrena (2 states)	Evaluate impact of format on pediatric healthcare quality and costs Learn to use data from the format to improve quality and reduce costs Determine how to promote meaningful use of the format Identify issues with the format, such as interoperability or privacy concerns	Test format’s usefulness with 4 health systems and a federally qualified health center (Pennsylvania) Elements Provided health care organizations funding to incorporate new Format requirements into their EHR systems Assessed usefulness of the format
E Additional activities to enhance work under another category or improve quality in another CMS priority area (11 states)	Demonstrate if new or expanded model of care to improve quality of children’s health care can be implemented Learn how best to implement these models and identify how barriers can be overcome Determine impact of model of care	Improve access to and quality of crisis response and family support services (Maryland) Elements Held focus groups with families and youth on crisis response and peer support Revised service delivery structure for mobile crisis and peer support services

Source: CMS’s solicitation for the CHIPRA Quality Demonstration Grant Program; analysis of data collected by the national evaluation team through interviews and document review PCMH patient centered medical home, SBHC school-based health center, CME care management entities, which aim to improve services for children and youth with serious emotional disorders

^aThe model EHR format was developed under a separate AHRQ contract, in partnership with CMS