Abstract
Objectives The objective of this study was to describe factors that influence the ability of state Medicaid agencies to report the Centers for Medicare & Medicaid Services’ (CMS) core set of children’s health care quality measures (Child Core Set). Methods We conducted a multiple-case study of four high-performing states participating in the Children’s Health Insurance Program Reauthorization Act (CHIPRA) Quality Demonstration Grant Program: Illinois, Maine, Pennsylvania, and Oregon. Cases were purposively selected for their diverse measurement approaches and used data from 2010 to 2015, including 154 interviews, semiannual grant progress reports, and annual public reports on Child Core Set measures. We followed Yin’s multiple-case study methodology to describe how and why each state increased the number of measures reported to CMS. Results All four states increased the number of Child Core Set measures reported to CMS during the grant period. Each took a different approach to reporting, depending on the available technical, organizational, and behavioral inputs in the state. Reporting capacity was influenced by a state’s Medicaid data availability, ability to link to other state data systems, past experience with quality measurement, staff time and technical expertise, and demand for the measures. These factors were enhanced by CHIPRA Quality Demonstration grant funding and other federal capacity building activities, as hypothesized in our conceptual framework. These and other states have made progress reporting the Child Core Set since 2010. Conclusion With financial support and investment in state data systems and organizational factors, states can overcome challenges to reporting most of the Child Core Set measures.
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Acknowledgments
All phases of this study were supported by a contract with the U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality (HHSA290200900019I/HHSA29032004T). The views expressed in this paper are those of the authors. No official endorsement by any agency of the federal government is intended or should be inferred. The authors wish to acknowledge Brenda Natzke, M.P.P., and Michaela Vine, M.P.H., from Mathematica Policy Research for research support; Margo Rosenbach, Ph.D., from Mathematica Policy Research; Cindy Brach, M.P.P., and Linda Bergofsky, M.S.W., M.B.A., of the Agency for Healthcare Research and Quality; and Barbara Dailey, M.S., and Elizabeth Hill, M.H.S., of the Centers for Medicare & Medicaid Services, for contributing to case selection and providing valuable comments. We also thank the demonstration project staff, state Medicaid agency staff, and other stakeholders who provided information for the case studies, particularly Gwen Smith, B.A. and Julie Doetsch, M.A. (Illinois); Kyra Chamberlain, M.S. (Maine); Charles Gallia, Ph.D., and Oliver Droppers, Ph.D. (Oregon); and David Kelley, M.D. (Pennsylvania).
Funding
All phases of this study were supported by a contract with the U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality (HHSA290200900019I/HHSA29032004T).
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Christensen, A.L., Petersen, D.M., Burton, R.A. et al. What Factors Influence States’ Capacity to Report Children’s Health Care Quality Measures? A Multiple-Case Study. Matern Child Health J 21, 187–198 (2017). https://doi.org/10.1007/s10995-016-2108-8
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DOI: https://doi.org/10.1007/s10995-016-2108-8