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

Publication Year: 2018
Patient Need Addressed: Behavioral health, Care Coordination/Management
Population Focus: Medicaid beneficiaries
Demographic Group: Child
Intervention Type: Staff design and care management, Technology/innovation
Type of Literature: Grey
link: https://www.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/statesummaries/chipra-750-wyoming-state-snapshot.pdf
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
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