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Program objectives

In its solicitation for grant applications, CMS encouraged multi-State partnerships to increase the number of participating States and promote the spread of knowledge and experience.

State strategies          

Six of the demonstration grants involved multi-State partnerships involving a total of 14 States.¹⁰ Partners used combinations of the following strategies to foster communication and collaboration:

• Hiring independent organizations to convene the partners and foster learning across States.
• Developing joint projects, integrating activities, and setting up complementary implementation schedules.
• Sequencing the implementation of their separate programs so the later implementers could learn from the partners that went before them.
• Pooling resources, including both expertise and funds, to co-develop QI tools and survey strategies.
• Sharing information through activities such as visiting each other’s administrative offices and implementation sites, trading key materials and reports, and scheduling regular teleconferences or in-person meetings.
• Conducting mutual site visits and structured learning collaboratives for demonstration staff.

Lessons learned

The multi-State partnerships created for this grant program led to substantial transfer of knowledge across partners with respect to specific tools for assessing quality of care and overall approaches for QI. Managing a successful partnership requires States to set aside time and resources to address challenges in scheduling meetings, coordinating site visits, and resolving conceptual differences across teams.

Analysis of the projects implemented by the 14 demonstration States involved in multi-State partnerships yielded the following insights:

• Unlike single-State grantees, States in partnerships can:
  • Combine and otherwise leverage several funding sources and build on existing efforts in each partner State to implement their projects.
  • Draw on a wider pool of resources and expertise to fill gaps in expertise and capacity.
  • Share tools and training resources.
  • Apply lessons learned from each other to avoid repeating mistakes and improve the quality of their projects.
  • Expand the spread and potential impact of demonstration projects.
• States are more apt to benefit from partnering when each brings complementary rather than equivalent expertise to the relationship and when they actively support each other in building key capabilities.
• Because partnering entails logistical complexities (for example, more meetings, working across time zones) State teams need to be prepared for projects to take longer to implement.  
• External consultants can help overcome the challenges of administering a multi-State demonstration and realize the potential benefits of working together.