State contracting initiatives for quality improvement in asthma care

This article examines the role of a state Medicaid program in standardizing and implementing quality performance measures for providers. It describes the Asthma Education and Primary Care Clinician Linkages Quality Improvement Program (QIP), one aspect of the ongoing Hospital Quality Initiative in Massachusetts. In October 1996, the second year of the initiative, the Massachusetts Division of Medical Assistance requested that all contracting hospitals submit quality improvement process and outcome measures related to asthma care, including practice guidelines, patient education materials, and documentation mechanisms to facilitate patients' appropriate follow-up contact with primary care clinicians. A team of evaluators reviewed these materials to determine whether hospitals had baseline data in place for asthma QIP development. Information forums were held with three reviewers and the hospitals to discuss various programs and progress toward quality improvement in asthma care. Reviewers also worked to identify hospital programs that could be used as models and those that would benefit from assistance in meeting the state's program goals.