The National Evaluation of the CHIPRA Quality Demonstration Grant Program: Spotlight on New Mexico

Publication Year: 2015
Patient Need Addressed: Behavioral health
Population Focus: Medicaid beneficiaries
Demographic Group: Child
Intervention Type: Best practices, Service redesign, Technology/innovation
Type of Literature: Grey

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

New Mexico’s Goals: Work with school-based health centers to improve care for adolescents by 1) implementing a new quality improvement process 2) implementing an electronic screening tool 3) engaging youth in their care and 4) promoting the patient-centered medical home model

Insights Results

Overview of model

  • New Mexico hired quality improvement (QI) coaches to help school-based health centers (SBHCs) to carry out QI projects using quality reports
  • To improve quality, SBHCs increased documentation of early and periodic screening, diagnostic, and treatment (EPSDT) preventive services, scheduled regular follow-up appointments for youth that are overweight and developed EHRs templates to guide screening for sexually transmitted inactions (STIs)
  • With the demonstration, the percent age of adolescents at SBHCs with documented EPSDT recommended services increased from 66% to 83%
  • Middle schoolers and high schoolers at SBHCs were screened electronically for social and behavioral risk factors (e.g., unsafe home environment, substance abuse); SBHC staff indicated that the electronic screener helped them identify adolescents who needed additional counseling or services
  • The State developed a Youth Engagement with Health Services survey to assess youth health literacy statewide; the results informed new youth engagement strategies and helped to tailor SBHC staff training
  • SBHCs implemented medical home features, establishing formal referral relationships with community providers and referring youth to the State’s 24/7 nurse help line

    Key takeaways/implications

    • Partnerships: New Mexico partnered with Colorado to design and implement strategies across both states
    • Challenges: 1) Competing priorities for staff time, continued need for staff training and system incompatibility at SBHCs made implementing projects challenging; and 2) SBHC are concerned about not having the resources to continue the new QI projects