Successes from the CHIPRA Massachusetts Medical Home Initiative
The Children’s Health Insurance Program Reauthorization Act (CHIPRA) Massachusetts Medical Home Initiative consists of 13 pediatric practices that are transforming their offices into patient-centered medical homes. The National Initiative for Children’s Healthcare Quality has made available information, findings, and promising practices from the initiative.
Fallon Turns to PCMH Model to Address Massachusetts Universal Care Requirements
Moving toward a medical home model has helped Fallon Clinic in Leominster address that challenge. The team-based approach has increased efficiency. The clinic's staff calls patients who are due for visits and screenings; patients between ages 50 and 75 receive birthday cards that include a reminder of tests or immunizations they are soon due to receive. Fallon uses 90-minute group visits, which increase "facetime" and optimize the amount of information discussed with the clinician.
Massachusetts' New Health Law Promotes Medical Homes
The state has enacted S.2400 into law. This omnibus law seeks to improve healthcare quality and reduce costs in the Commonwealth, building off the landmark legislation passed in 2006 and 2008. The Act, which includes a state definition for patient-centered medical home (PCMH), requires a newly formed commission to develop certification standards, a training program, and a model payment system for PCMH by January 2014.
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Medical Home Chapter Champions Program on Asthma (MHCCPA)
Through the support of the Merck Childhood Asthma Network, Inc. (MCAN), the MHCCPA facilitates the dissemination of best practices and advocacy related to the implementation of the National Heart, Lung, and Blood Institute (NHLBI) asthma guidelines within the medical home framework. Program goals include identifying a champion at the AAP chapter and/or state level(s) to educate/mentor providers in their communities, in addition to increasing advocacy efforts, for implementation of the NHLBI guidelines within the context of a medical home. If you would like more information about the project, would like to be connected with your chapter/state's champion , or are interested in serving as a chapter champion if your chapter/state does not currently have one, contact us at 847/434-4311 or fill out the Contact Us form.
Children's Health Insurance Program Reauthorization Act (CHIPRA) Grants—Cycle I
Massachusetts is a lead on one of 10 CHIPRA grants, representing single-state projects and multi-state collaborations, from HHS to improve health care quality and delivery systems for children enrolled in Medicaid and the Children's Health Insurance Program (CHIP). The money will help states implement and evaluate provider performance measures and utilize health information technologies such as pediatric electronic health records and other quality improvement initiatives.
The State will work with the University of Massachusetts Medical School, the Children's Hospital of Boston, the Massachusetts Health Quality Partners, and the National Initiative for Children's Healthcare Quality to apply and evaluate recommended measures of children's health care quality and to make comparative quality performance information available to providers, families, and policymakers. The State will also use learning collaboratives and practice coaches to support the process of transforming pediatric practices into medical homes that provide family and child-oriented care, measure and improve that care, and enhance outcomes, particularly for children with targeted conditions: Attention Deficit and Hyperactivity Disorder, asthma, and childhood obesity.
- Massachusetts Medical Home Initiative Announces Teams
Fourteen pediatric practices across Massachusetts have been chosen to participate in this 5-year long initiative. Meet the practices that will redesign themselves in order to adopt the "medical home" model of care.
LEND Programs Receive Funding to Improve the Health of Children with Special Health Care Needs
The Health Resources and Services Administration (HRSA) has awarded $28.3 million to 43 Leadership Education in Neurodevelopmental and Other Related Disabilities (LEND) programs, including the programs at the University of Massachusetts Medical School and the Children's Hospital, to help improve the health of infants, children, adolescents and young adults with neurodevelopmental and other related disabilities, including autism spectrum disorders. LEND programs prepare trainees from a wide variety of professional disciplines to assume leadership roles, ensure high levels of interdisciplinary clinical competence, and enhance the ability of clinicians to diagnose, treat, and manage complex disabilities in youth and adolescents.
Aligning Forces for Quality (AF4Q) Initiative—Massachusetts
Massachusetts is a participant in the AF4Q project led by Massachusetts Health Quality Partners (MHQP) and the Eastern Massachusetts Healthcare Initiative (EMHI) and is supported by more than 35 Boston-area organizations. The Greater Boston Quality Coalition's (GBQC) mission is to create substantive change and sustained improvement in the area's health care system through community-wide performance measurement and reporting, consumer engagement and quality improvement efforts.
Aetna Foundation Awards Grants to Study PCMH
Aetna Foundation provided $250,000 to Massachusetts General Hospital (MGH) in Boston, Mass., to study whether intensive care management and integrated care can improve the health outcomes of economically disadvantaged patients with multiple chronic conditions while decreasing the cost of their treatment. The research team, will evaluate a new integrated primary care program launched in 2010 by Cambridge Health Alliance that serves a diverse population of low-income children and adults with two or more chronic conditions. The Massachusetts-based program assigns each patient to a primary care doctor who coordinates treatment, and, as needed, adds an interdisciplinary team of nurse practitioners, clinical nurse psychologists, social workers and community health workers to help patients manage their health. The two-year study will examine the barriers in implementing the program, assess patient satisfaction with the program's care coordination, communication and quality, and quantify the cost of care.
Patient-Centered Outcomes Research Institute (PCOI) Pilot Projects Program
PCOI has approved 50 Pilot Projects Program awards, totaling $30 million over two years. The awarded projects include programs working to develop tools and techniques for improving patient-centered care and decision-making; create new patient-centered care measures; and improve delivery of patient-centered counseling and care in various health care settings. One funded pilot projects that relates to providing medical home services for all children and youth is Incorporating Parent Preferences in Decision Making About Childhood Vaccines—Harvard Medical School .
Consortium to Advance Medical Homes for Medicaid and CHIP Participants
National Academy for State Health Policy (NASHP)—January 2011
Fifteen state teams were brought together by the NASHP to form a Consortium to Advance Medical Homes for Medicaid and Children's Health Insurance Program (CHIP) Participants. These states will work together to develop and implement policies that increase Medicaid and CHIP program participants' access to high performing medical homes. This past spring, the kick-off meeting was held for the 15 participating states (Alabama, Colorado, Maryland, Massachusetts, Michigan, Minnesota, New Mexico, New York, North Carolina, Oklahoma, Oregon, Pennsylvania, Rhode Island, Vermont and Washington); the blog post—Constructive Ideas from Medical Home Builders—features an interview with NASHP policy analyst Jason Buxbaum about the Consortium states' medical homes projects.
Massachusetts Patient-Centered Medical Home Initiative
Through this mulit-payer initiative, the Massachusetts Executive Office of Health and Human Services (EOHHS) has set the goal for all primary care practices in Massachusetts to become patient-centered medical homes by the year 2015. Practices selected to participate will follow a three-year transformation plan that involves attending nine full-day learning collaborative sessions over 24 months, working with medical home facilitators, submitting monthly reports based on a patient registry, and applying for medical home recognition by the National Committee for Quality Assurance (NCQA) within 18 months of the start of the Initiative, which is currently slated for early 2011.
The Safety Net Medical Home Initiative
In May 2008, The Commonwealth Fund, Qualis Health and the MacColl Institute for Healthcare Innovation at the Group Health Research Institute initiated a demonstration project to help safety net primary care clinics become high-performing patient-centered medical homes (PCMHs). Five Regional Coordinating Centers were selected to participate in the demonstration project, and each partnered with 12-15 safety net clinics in their state. These collaboratives will receive technical assistance on practice re-design topics such as enhanced access, care coordination, and patient experience. They will also receive funding to support a Medical Home Facilitator (who will lead clinic-based quality improvement projects) and other activities. The work of the Regional Coordinating Centers began in April 2009 and the Initiative will continue through April 2013.
MCHB Medical Home Grant—The Massachusetts Medical Home Project
A medical home development project funded by the MCHB which partners care coordinators from the Dept of Public Health with primary care pediatricians in the community.
National Center for Children’s Vision and Eye Health
Prevent Blindness America—the nation’s leading volunteer eye health and safety organization—has established the National Center for Children’s Vision and Eye Health, made possible by a multi-year cooperative agreement from the MCHB. The program is designed to serve as a major resource for the establishment of a public health infrastructure to advance and promote children’s vision and eye care, as well as provide leadership development, health promotion, education, and training to public and private entities throughout the US.
National Asthma Control Initiative (NACI) Demonstration Projects (2012-2013)
The National Heart, Lung, and Blood Institute’s NACI has announced funding of 13 demonstration projects across the US, including a project in Massachusetts, aimed to develop, implement, and test science-based approaches to improve asthma control using evidence-based national guidelines for diagnosis and managing asthma. Additionally, the NACI Web site hosts a variety of tools for health care professionals related to diagnosis and treatment of asthma.
Health Resources and Services Administration (HRSA) in Your State
HRSA in Your State offers overviews of HRSA programs and current information, such as the number and amount of grants awarded down to the County level. It also provides state-specific information about health centers, National Health Service Corps members and the communities they serve, and the number of participating providers through the 340B program.
Early Childhood Comprehensive Systems (ECCS) State Contacts
The Maternal and Child Health Bureau (MCHB) launched the State Maternal and Child Health Early Childhood Comprehensive Systems (ECCS) Initiative to implement the MCHB Strategic Plan for Early Childhood Health. The purpose of ECCS is to support states and communities in their efforts to build and integrate early childhood service systems that address the critical components of access to comprehensive health services and medical homes; social-emotional development and mental health of young children; early care and education; parenting education, and family support. For additional information, you can look up your state's ECCS Grantee Contact or Grantee Web site.
AAP: Community Pediatrics Grant Database
The Community Pediatrics Grant Database archives previously funded Community Pediatrics grant projects, including those funded through the CATCH Program, the Healthy Tomorrows Partnership for Children Program, the Community Pediatrics Training Initiative and the Healthy People 2010 Chapter Grants. The database is searchable by seven major categories: target population, health topic, state/territory, project activity, AAP program, AAP district, and project year. Members of the AAP can obtain grantee contact information by searching through the Member Center. If you are not an AAP member, but have questions please contact email@example.com.
This page houses information on funding opportunities from the AAP and other organizations, as well as links to other key funding contacts and resources.
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This section provides information on state organizations that play a role in implementing various aspects of medical home, and includes links to their Web sites and contact information.
American Academy of Pediatrics (AAP) Chapter—Massachusetts
AAP chapters are organized groups of pediatrician members and other health care professionals working to achieve AAP goals in their communities. Please contact your local chapter for additional state resources.
American Academy of Family Physicians (AAFP) Chapter—Massachusetts
AAFP represents more than 94,000 family physicians, family medicine residents, and medical students.
Family Voices Chapter—Massachusetts
Family Voices aims to achieve family-centered care for all children and youth with special health care needs (CYSHCN) and/or disabilities. Through a national network of chapters, they provide families with tools to advocate for improved public and private policies, and build partnerships among professionals and families.
Family-to-Family Health Information Centers (F2F HICs)
F2F HICs are non-profit organizations that help families of CYSHCN and the professionals who serve them. F2F HICs are typically staffed by parents of CYSHCN who understand the issues that families face, provide advice, offer resources, and tap into a network of other families and professionals for support and information.
Mass Family Voices at Federation for Children with Special Needs
Address: The Schrafft Building, 529 Main Street, Suite 1102, Boston, MA 02129
Phone: 617/236-7210 | Toll-Free: 800/331-0688
Primary Contact: Beth Dworetzky
Title V Maternal and Child Health (MCH) Director & Children with Special Health Care Needs (CSHCN) Director
Title V of the Social Security Act is the nation's oldest federal program to improve the health of all mothers, infants, children, adolescents, and CSHCN. Title V is administered by the Federal Maternal and Child Health Bureau (MCHB) as a block grant to states to support core public health functions, such as care coordination and rehabilitation services.
Early Hearing Detection & Intervention (EHDI) Contact(s)
State EHDI programs promote universal newborn hearing screening, develop effective tracking and follow-up as a part of the public health system, promote appropriate and timely diagnosis of hearing loss, prompt enrollment in appropriate early intervention, ensure a medical home for all newborns, and strive to eliminate geographic and financial barriers to service access.
State Newborn Screening & Genetics Programs
Early Intervention/Part C Coordinators
The Program for Infants and Toddlers with Disabilities (Part C of IDEA) is a federal grant program that assists states in operating a comprehensive statewide program of early intervention services for infants and toddlers with disabilities, ages birth through age 2 years, and their families.
State Section 619/Special Education for ages 3-5 Coordinators
This program provides free appropriate public education (FAPE) for children, ages 3 through 5 years, with disabilities.
State Interagency Coordinating Council (ICC) Chairs
This program advises appropriate agencies on the unmet needs in early childhood special education and early intervention programs for children with disabilities, assists in the development and implementation of policies that constitute a statewide system, and assists all appropriate agencies in achieving full participation, coordination, and cooperation for implementation of statewide system.
Children's Health Insurance Program (CHIP)
CHIP is Title XXI of the Social Security Act and is a state and federal partnership that targets uninsured children and pregnant women in families with incomes too high to qualify for most state Medicaid programs, but often too low to afford private coverage. Within federal guidelines, each state determines the design of its individual CHIP program, including eligibility parameters, benefit packages, and administrative procedures. The Children's Health Insurance Program Reauthorization Act (CHIPRA) of 2009 re-authorized the program through FY 2013, and includes many incentives for states to find and enroll more eligible children in both Medicaid and CHIP. CHIPRA also includes quality provisions that aim to monitor and improve care delivered through the Medicaid and CHIP programs. Each state does have a CHIP program, and the names of these programs differ from state to state. To find information on health coverage programs in your state, visit the InsureKidsNow.gov Web site.
Medicaid State Directors
Medicaid is Title XIX of the Social Security Act and is a federal/state entitlement program that provides medical assistance to certain individuals and families with low incomes and/or special health care needs. Medicaid is of unique importance to children; together with the CHIP, Medicaid insures more than one in four children in the United States, with millions more eligible but currently unenrolled. The Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program is a critical component of Medicaid, which guarantees that children enrolled in Medicaid are screened for medical or developmental problems early, and that necessary treatments and services are provided. To find information on health coverage programs in your state, visit the InsureKidsNow.gov Web site.
- Medicaid State Reports—2011
The American Academy of Pediatrics, in partnership with the National Association of Children's Hospitals, has created fact sheets that explain the importance of the Medicaid program, and how children in every state rely on it for their health care.
Community Health Centers in the State
HRSA provides a searchable database of federally-funded health centers. Health centers provide care to those with or without health insurance including well-care check ups, treatment when sick, complete care during pregnancy, immunizations and checkups for children, dental care, prescription drugs, and mental health and substance abuse care.
Help Me Grow
Health Me Grow (HMG) is a collaborative, cross-sector system that assists states in identifying at-risk children, then helping families find community-based programs and services. The organization and its affiliates do not provide direct services. Rather, it is a system for improving access to existing resources and services for children through age eight. States affiliated with the Help Me Grow National Center use the HMG system to implement effective, universal, early surveillance and screening for all children, and then link them to existing quality programs.
Health Leads is a volunteer-driven service to connect patients and their families with the basic resources they need to be healthy. With Health Leads, doctors can "prescribe" resources such as food, housing and heating assistance—just as they do medication. Patients take their prescriptions to the clinic waiting room, where volunteers help "fill" them by connecting patients to community services. Health Leads' 21 desks are located in pediatric outpatient, adolescent, and prenatal clinics, newborn nurseries, pediatric emergency rooms, health department clinics, and federally qualified health centers.
Massachusetts Family Ties
Family TIES of Massachusetts provides parent-to-parent support, information and referral services, and workshops to ensure that parents feel confident in caring for your children with special needs.
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Association of Maternal and Child Health Programs (AMCHP)—Massachusetts State Profile
These state profiles provide a snapshot of how the Maternal and Child Health Block Grant (Title V) works in specific states. The profiles detail the federal funds appropriated to each state, state match, specific programs funded, numbers of people receiving services and state health needs.
Early Childhood State Policy Profiles
National Center for Children in Poverty (NCCP)
NCCP’s Early Childhood Profiles were produced as part of the Improving the Odds for Young Children project. These comprehensive profiles highlight states’ policy choices that promote health, education, and strong families alongside other contextual data related to the well-being of young children.
Issue Brief: Implementing the Medical Home in Medicaid, CHIP, and Multistakeholder Demonstration Programs
American Academy of Pediatrics (Member access only)
This Issue Brief serves to provide guidance to AAP chapters working with states to implement medical home projects in Medicaid and CHIP as well as multipayer demonstration programs. It also addresses a number of the policy questions that frequently arise in creating state supports for the medical home.
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Medical Home Data Portal—State Data Pages
Child and Adolescent Health Measurement Initiative
The Medical Home State Data Portal profiles provide a state’s medical home performance level for all children and children with special health care needs, based on data from the 2009/2010 National Survey on Children with Special Health Care Needs, 2007 National Survey on Children's Health and the 2005/2006 National Survey of Children with Special Health Care Needs.
Child Health USA 2010
US Department of Health and Human Services, Health Resources and Services Administration
This report is the 17th edition of the annual statistical report that highlights the health status and service needs of America's children. The report contains easy-to-access graphs and charts summarizing significant indicators of children's health status, statistics, figures, and references.
America's Children: Key National Indicators of Well-Being, 2011
Federal Interagency Forum on Child and Family Statistics
The purposes of the report are to improve Federal data on children and families and make these data available in an easy-to-use, non-technical format. It organizes well-being indicators into seven sections: family and social environment, economic circumstances, health care, physical environment and safety, behavior, education, and health.
KIDS COUNT Databook
Annie E Casey Foundation
This report is a national and state-by-state profile of the well-being of America's children available as an interactive databook, a complete PDF-format report, and on request, in print. Data and rankings on 10 key indicators of child well-being are available by state, county, and city.
State-at-a-Glance Chartbook on Coverage and Financing for Children and Youth with Special Health Care Needs
The Catalyst Center
The Online State-at-a-Glance Chartbook provides data on carefully selected indicators of health coverage and health care financing for CYSHCN. Using the online Chartbook, you can access data for your state and easily compare it with both national averages and other states' data.
National Healthcare Quality & Disparities Reports
Agency for Health Research and Quality (AHRQ)
50-State Demographics Wizard
National Center for Children in Poverty (NCCP)
This tool allows you to create custom tables of national- and state-level statistics about low-income or poor children. Choose areas of interest, such as parental education, parental employment, marital status, and race/ethnicity—among many other variables.
Adolescent Health Database
National Adolescent Health Information Center (NAHIC)
The NAHIC database includes national and state-level profiles of key measures of the health of adolescents and young adults. National-level data is available by gender and race/ethnicity and also state-by-state, with summaries, data tables, and guidance for using this data to improve the health of adolescents and young adults.
Medical Home Data Fact Sheet—January 2009
American Academy of Pediatrics
To inform key aspects of the pediatric medical home, the AAP has compiled a data fact sheet of summary statistics and facts from various AAP and public and proprietary sources. These data define the current state of pediatric care, and as the efforts surrounding the promotion and expansion of the pediatric medical home accelerate, the fact sheet will change to reflect this new picture.
Profile of Pediatric Visits—April 2010
American Academy of Pediatrics
This report is based on the most current available four years worth of NAMCS and MEPS data (2004-2007). The updated report includes annualized estimates by source of payment, patient age, physician specialty, well vs sick visit, office setting, practice ownership, physician employment status, and geographic location.
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AAP Child Health Informatics Center—State and Territory Specific HIT Resources
This page on the AAP AAP Child Health Informatics Center (CHIC) Web site allows you to identify pediatric specific HIT resources by state related to Meaningful Use, Regional Extension Centers, State Health Information Exchanges, and other important information.
Linking Medical Home and Children's Mental Health: Listening to Massachusetts Families
This report, published by the Parent-Professional Advocacy League in collaboration with the Central Mass Medical Home Network Initiative, looks at the experiences of families who have children have mental health needs in accessing and coordinating care for their children. It discusses the challenges associated with accessing mental health care and coordinating it with a child's medical care.
Medical Home Materials
Massachusetts Consortium for CSHCN
The Massachusetts Consortium for CSHCN is a working group dedicated to improving systems of care for children with special health care needs and their families throughout the Commonwealth of Massachusetts. The Consortium offers a forum for information exchange and strategic thinking to address gaps and barriers in service systems.
Practicing Comprehensive Care: A Physician's Operations Manual for Implementing a Medical Home for CSHCN
This manual, created by the Pediatric Alliance for Coordinated Care, offers practical advice and suggestions to support the day-to-day operations of pediatric offices to more efficiently and effectively serve children with special health care needs.
Transition Planning for Adolescents with Special Health Care Needs and Disabilities: A Guide for Health Care Providers (2000)
guide gives information, resources and strategies needed by providers to support adolescents and their families to meet the challenges of transition.
Transition Planning for Adolescents with Special Health Care Needs and Disabilities: Information for Families and Teens (2000)
This booklet has been developed for families to help prepare teens for adulthood.
Partnerships for Quality: A Forum on Managed Care and Children with Special Health Care Needs in Massachusetts
Partnerships for Quality is a forum for parents, providers, and managed care plans to discuss key issues for children with special health care needs, share information and create connections and strategies for improving health care quality. This site hosts transcripts and resources from this conference held by MA Family Voices that brought together families and health professionals to discuss how to improve care for CSHCN.
The Medical Home Network Project
This educational program of New England SERVE brings together primary care providers, parents and community partners to demystify the theory and practice of the Medical Home. Its case-based curriculum offers knowledge, awareness, and strategies for implementing small practice improvements. Sessions include: Introduction to Medical Home, CSHCN, Family Centered Care; Community Resources and Care Coordination; and Medical Home Index and Practice Change. These two-hour sessions carry continuing medical education (CME) approval.
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