The National Evaluation of the CHIPRA Demonstration Grant Program: Spotlight on Maryland

Publication Year: 2018
Patient Need Addressed: Behavioral health, Care Coordination/Management, Oral health
Population Focus: Medicaid beneficiaries
Demographic Group: Child
Intervention Type: Staff design and care management
Type of Literature: Grey

This brief highlights the major strategies, lessons learned, and outcomes from Maryland’s experience from February 2010 to February 2016 with the quality demonstration funded by the Centers for Medicare & Medicaid Services (CMS) through the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA).

Maryland’s Goals: Improve the quality and reduce the cost of care for children with serious behavioral health challenges by 1) refining care management entities to improve coordination across child- serving agencies 2) enhancing the accessibility and quality of services and supports for youth and their families

Insights Results

Overview of model

  • Maryland obtained substantial funding for Care Management Entities (CMEs), integrated oral and physical health into CME training / services and developed materials on best practices for crisis response
  • Stable funding for CMEs came from care coordination organizations (CCOs) that were funded under the 1915 State Plan Amendment; this restructuring allowed CME services to support more youth
  • The State required providers to deliver new CME services and implement new standardized tools to monitor quality that minimized reporting burden and tracked youth eligibility for CME services and their outcomes

    Key takeaways/implications

    • Insight: Maryland learned from stakeholders that family support and crisis response services were not always available and did not meet individual needs. This was linked to low reimbursement rates, staff turnover and poor organizational structure
    • Partnerships: Georgia and Wyoming implemented similar projects; all three states met with the Center for healthcare Strategies to learn and collaborate
    • Challenges: data inconsistencies caused significant delays to efforts to analyze data to support CME quality improvement