Abstract
This brief highlights the major strategies, lessons learned, and outcomes from Wyoming’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).
Wyoming’s Goals: Improve services for children with complex behavioral needs by 1) piloting a care management entity (CME) to improve coordination across child-serving agencies 2) integrating CME services with other health information technology initiatives in the State
Insights Results
Overview of model
Wyoming developed its first care management entity (CME) with the help of staff representing various child-serving agencies across the state
Key takeaways/implications
Insight: Wyoming made insightful decisions to help it understand its design options. The state: 1) Analyzed data from prior project in behavioral health; 2) Dedicated specific staff to lead CME development; and 3) Consulted both with a contractor that had CME expertise and experience states
Key features of the CME: 1) Served youth ages 4 to 21 who had a serious qualifying mental health diagnosis or who qualified for services at a residential treatment center; and 2) Contracted with behavioral health providers and community based non-profits to deliver intensive care coordination and family support services
The CME had to conduct outreach and education to encourage providers to refer youth to it
Piloting the CME in a seven-county region first allowed the State to evaluate and refine the model before implementing it statewide
Wyoming integrated its existing health information technology into CME activities; CME providers used the total health record feature to identify participants’ needs and used telehealth to improve participants’ access to care
Challenges: The designing of Wyoming’s CME was overall a complex and lengthy undertaking which took longer than expected. The state faced several design challenges, including agencies’ competing priorities and stakeholders’ steep learning curve