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

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