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Children’s Healthcare Access Program (CHAPs)

The Children’s Healthcare Access Program (CHAPs) aims to enhance pediatric healthcare access and outcomes. The first year results from the initiative show a remarkable 9% decrease in emergency room use and a 16% reduction in inpatient admissions across 17,000 children tracked in various healthcare settings. Key strategies included improved payment for primary care services, same-day appointments, and community collaboration. Challenges such as leadership engagement and the incorporation of CHAPs competencies into health plan operations have been identified, emphasizing the importance of incentives and strategic collaboration.

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Children’s Healthcare Access Program (CHAPs)

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  1. Children’s Healthcare Access Program (CHAPs) Thomas H. Peterson, M.D. PCPCC Stakeholders Collaborative March 30, 2010

  2. CHAP Commitments First Steps Board Strategy Financial Support • Priority Health •  payment for primary care services, incentives • Reporting • Measure results • CHAP Staff • Same day transportation • Patient education • No-show avoidance • Clinical • Social services referrals • Physicians •  access •  throughput • Attend meetings Collaboratives Patient-Centered Care Triple Aim Outcomes 3

  3. Outcomes Year 1 (Independent Evaluator) • Tracked 17,000 kids in private practices, FQHC, and DeVos Children’s Hospital Pediatric Clinic • Overall results Year 1: • ER use decreased by 9% • Inpatient use decreased by 16% • Most dramatic progress at: • DeVos--15% decrease in ED use—same-day app’ts. • FQHC --9% decrease in ED use, 22% decrease in admissions • Open scheduling, evening hours, increased throughput • Increased clinical time for providers + visits/hour • Improved quality metrics • Different payment strategies 4

  4. Lessons Learned (So Far) • Change is hard, but possible • Leadership is critical • So is collaboration • Incentives matter, but they just set the table—professional pride quickly takes over • Good news travels 5

  5. What Incentives Contributed? • Economics • Direct increases in payment • Bonus payment for improved performance • Community Collaborative • Transparency—reporting, provider meetings • Professional pride 6

  6. Strategic Challenges • Incorporating CHAPs competencies into health plan operations (Foundations won’t support forever) • Spread of payment improvements to entire Medicaid network

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