Abstract
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
