Children's Health Insurance Program Reauthorization Act (CHIPRA)

Young boy with female doctorWith a common goal of improving health outcomes for children, leaders from Maine and Vermont are parterning on a 5-year quality demonstration grant funded through the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA). This cross-state partnership recognizes and builds upon the existing strength and leadership in improving child health access and quality as reflected through low child uninsured rates, generous Medicaid and Child Health Insurance Program (CHIP) benefits, and high national performance rankings on child health.

Vermont and Maine were among the first states to pass comprehensive health reform legislation, with quality improvement representing a critical sustainability component. Building on robust quality infrastructures, the Department of Vermont Health Access and the Office of MaineCare Services (Vermont and Maine Medicaid, respectively) identified a number of statewide initiatives to improve child health quality over the 5-year period. In Vermont, foci include technical and infrastructure support for the expansion of the Vermont Blueprint for Health to pediatric practices as well as spread of an innovative model of public/private healthcare partnerships across the United States through the National Improvement Partnership Network (NIPN).


  • Expanding and supporting use of the Vermont Blueprint for Health central clinical registry (Covisint/DocSite) to support care in the pediatric population.
  • Extending the Blueprint Advanced Primary Care Practice model to child-serving practices by supporting National Committee for Quality Assurance (NCQA) Patient-Centered Medical Home assessments and practice facilitation for ongoing quality improvement.
  • Expanding the number of states with an Improvement Partnership program and evaluating the model as an effective strategy for improving the quality of children’s health care.


  • Initially funded by CHIPRA, as of November 2014, a total of 21 practices and 84 practices that serve both children and adults in Vermont have been formally recognized as NCQA Patient-Centered Medical Homes.
  • The current network of Improvement Partnership states – the National Improvement Partnership Network (NIPN) – has expanded to over 20 states and regions.