Section 2

Enhancing

Since 2000, more than 130 Medicaid managed care organizations, including health

plans and PCCMs, representing nearly 14 million Medicaid beneficiaries in 37

Child

states, have participated in CHCS' Best Clinical and Administrative Practices

(BCAP) initiatives. These organizations work to improve health care services for

Development

millions of Medicaid beneficiaries by developing quality improvement projects using

the BCAP Quality Framework.

Services Using

the BCAP

Elements of the BCAP Quality Framework are adapted from learning models devel 

oped by the Institute for Healthcare Improvement (IHI) and others focusing on

Quality

chronic disease such as the Improving Chronic Illness Care (ICIC) program at the

McColl Institute for Healthcare Innovation.  The BCAP Quality Framework

Framework

includes four components:

BCAP Typology lends consistent structure to quality improvement activities.

Rapid Cycle Improvement allows testing of small changes and systematic analysis

of improvement processes.

Measurement and Evaluation enables health plans to measure short term process

changes and long term outcomes and to evaluate organizational capacity.

Sustainability and Diffusion promotes ongoing use of best practices and/or sys 

tematic use of BCAP Quality Framework across an organization and/or region for

long term success.

BCAP Typology for Improvement 

The BCAP Typology offers a template for designing quality initiatives that can be

customized per clinical or administrative focus area. The four typology categories

and examples of how plans applied each category to enhance child development

services are listed below. 

Identification

How does the health plan identify their 0 3 year old members? 

Stratification

How can the plan identify all children due or overdue for develop 

mental screening? How can the plan stratify providers to maximize 

the potential of pilot activities? 

Outreach

What can the health plan staff do to effectively reach families with 

member education materials or incentives for well child visits? How 

can health plan staff communicate the importance of developmen 

tal screening to their providers?

Intervention

What changes affect the rate of developmental screening for chil 

dren age 0 3? How can systems be changed to improve flow and 

efficiency in the provider office during a well child visit?  What can 

be done to improve referral practices?

While the typology is useful to provide structure in designing a quality improve 

ment initiative, there also can be overlap between typology categories. A successful

effort to improve identification, for example, can often promote activities in stratifi 

cation, outreach, and intervention. 

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