For those looking to build a partnership within the state, Dr. Davis said there are four key elements to have at the table; state health departments, state Medicaid agencies, state chapters of the American Academy of Pediatrics and the American Academy of Family Physicians (to help bring clinicians into the partnership), and the local academic community. Additionally, it is important to have patients at the table as well, she added.
“NIPN has been an essential mentor organization for our improvement partnership,” Dr. Cason Benton, director of the primary care clinic at the University of Alabama at Birmingham, said in an interview. “Because of NIPN, we created here in Alabama the Alabama Child Health Improvement Alliance (ACHIA). Prior to NIPN being involved, Alabama had been very active in bringing quality improvement work to pediatricians in the state, but we had sort of hit a wall of where we could go through one of the main organizations – the Alabama chapter of the AAP.”
NIPN’s guidance helped ACHIA bring together all the key stakeholders around improving children’s health: Children’s Hospital of Alabama, the University of Alabama at Birmingham, Alabama Medicaid, Blue Cross Blue Shield (one of the largest payers in the state), and the Alabama Department of Public Health.
In the year that ACHIA has been up and running, it already is starting to make a difference. Earlier, the group had hosted two learning collaboratives – one on screening for developmental delays and autism and the other on obesity prevention and treatment.
In the area of developmental screening, “standardized screens for the practices we were working with were not commonly used at the health supervision visits,” Dr. Benton said. “But through the collaborative, they were able to incorporate the screens into their practice work flow so that close to 100% of the children were receiving and completing the screens at their recommended ages, and the appropriate number of referrals to early intervention increased threefold.”
Results on ACHIA’s learning collaborative on obesity prevention will be presented at an upcoming state AAP meeting.
“With the collaborative model, we bring in both the administrative and the clinical staff as well as the physician, and with everybody working together, you are able to create more sustainable changes to the practice and to the work flow,” Dr. Benton said. “It’s well beyond the essential piece of just medical knowledge, but actually transforming the practice to be able to deliver this care in a reliable way.”
Dr. Davis said that in the past, private payers also have shown an interest, and their participation, along with that of Medicaid, is important, especially as payment is becoming more and more focused on quality. Understanding what quality measures payers are looking for can help set the agenda for areas that NIPN and its state partners look at to help ensure they will get paid for their work in the future.