New Implementation Guide Advises on Care Management Entity Design

AHRQ has published the second implementation guide from the Children's Health Insurance Program Reauthorization Act (CHIPRA) Quality Demonstration Grant Program. “Designing Care Management Entities for Youth With Complex Behavioral Health Needs” provides information about care management entities (CMEs), which coordinate services provided by state agencies that serve youth with complex behavioral needs. The implementation guide, available under What We Learned on the national evaluation website, draws on the experiences of the three CHIPRA quality demonstration states—Georgia, Maryland and Wyoming—that are using funds to implement or expand CMEs, supplemented with additional guidance and resources. The guide can be helpful to states interested in implementing or improving CMEs for youth with complex behavioral health needs and their families. It may also be useful for county agencies if they are responsible for financing behavioral health or social services in the state. AHRQ is leading the national evaluation of the CHIPRA Quality Demonstration Program. The Centers for Medicare & Medicaid Services funds the evaluation. If you have questions or comments, please contact the national evaluation team viaemail.

The CHIPRA quality demonstration States are pursuing innovative strategies to improve health care for children.

The National Evaluation team is disseminating the CHIPRA quality demonstration States' strategies, lessons learned, and outcomes through four mechanisms:

Evaluation Highlights

The national evaluation team is producing a series of issue briefs that frame the most pertinent evaluation findings for a variety of audiences concerned with children's health care quality. These 4-6 page briefs, entitled Evaluation Highlights, will include both descriptive and analytic findings depending on the topic and time period of the demonstration, and will be posted to this page as they become available.

Evaluation Highlight No. 10: How are CHIPRA quality demonstration States testing the Children's Electronic Health Record Format?

This Evaluation Highlight is the tenth in a series that presents descriptive and analytic findings from the CMS-funded national evaluation of the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) Quality Demonstration Grant Program. This Highlight focuses on how North Carolina and Pennsylvania are testing how well the Children's Electronic Health Record (EHR) Format's requirements support the provision of primary care to children and how readily the requirements can be incorporated into existing EHRs. The experiences and feedback from North Carolina and Pennsylvania have implications for States and other stakeholders interested in using EHRs as a tool for measuring and improving children's health care quality.

PDF version - 655.16 KB or HTML text.

Evaluation Highlight No. 9: How are CHIPRA quality demonstration States supporting the use of care coordinators?

This Evaluation Highlight is the ninth in a series that presents descriptive and analytic findings from the CMS-funded national evaluation of the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) Quality Demonstration Grant Program. The Highlight focuses on how six States—Alaska, Idaho, Massachusetts, Oregon, Utah, and West Virginia —are using grant funds to support practices' use of care coordinators by providing training, technical assistance, and/or funding as practices implement patient-centered medical home models.

PDF version - 731.19 KB or HTML text.

Evaluation Highlight No. 8: CHIPRA quality demonstration States help school-based health centers strengthen their medical home features

PDF version - 595.3 KB or HTML text.

Evaluation Highlight No. 7: How are CHIPRA quality demonstration States designing and implementing caregiver peer support programs?

PDF version - 585.23 KB or HTML text.

This Evaluation Highlight includes a supplement that describes the features of peer support programs across the States.

PDF version - 156.11 KB or HTML text.

Evaluation Highlight No. 6: How are CHIPRA quality demonstration States working together to improve the quality of health care for children?

PDF version - 549.27 KB or HTML text.

This Evaluation Highlight includes a supplement that describes the multi-State partnerships and the projects they are developing.

PDF version - 264.16 KB or HTML text.

Evaluation Highlight No. 5: How are the CHIPRA Quality Demonstration States encouraging health care providers to put quality measures to work?

PDF version - 655.33 KB or HTML text.

Evaluation Highlight No. 4: How the CHIPRA quality demonstration elevated children on State health policy agendas

PDF version - 578.52 KB or HTML text.

Evaluation Highlight No. 3: How are CHIPRA Quality Demonstration States working to improve adolescent health care?

PDF version - 547.59 KB or HTML text.

Evaluation Highlight No. 2: How are States and evaluators measuring medical homeness in the CHIPRA Quality Demonstration Grant Program?

PDF version - 924.92 KB or HTML text.

This Evaluation Highlight includes a supplement that provides information on two medical home measurement tools, the creation of a cross-State database, the methods for collecting the data analyzed in this Highlight, and explores the MHI-RSF in six demonstration States

PDF version - 164.77 KB or HTML text.

The Medical Home Index-Revised Short Form (MHI-RSF) is a medical home assessment tool being used in the CHIPRA quality demonstration.

PDF version - 563.9 KB ; HTML text; The Medical Home Index: Revised Short Form: Pediatric[ - 133.79 KB]

Evaluation Highlight No. 1: How are CHIPRA demonstration States approaching practice-level quality measurement and what are they learning?

PDF Version [

- 531.24 KB] or HTML text.

This Evaluation Highlight includes a supplement that describes the practice-level reporting efforts of the States featured in this Highlight. PDF Version [

- 229.19 KB] or HTML text.

Top of Page

Implementation Guides

Designing Care Management Entities for Youth with Complex Behavioral Health Needs

This Implementation Guide provides information about the process of designing care management entities (CMEs), which are designed to coordinate services provided by the many State agencies that serve youth with complex behavioral health needs. By ensuring services are comprehensive but not duplicative, CMEs can improve outcomes for these youth and their families and lower costs to States. This guide may be helpful to States interested in implementing or improving CMEs and for county agencies if they are responsible for financing behavioral health or social services in the State.

Engaging Stakeholders to Improve the Quality of Children's Health Care

This Implementation Guide includes suggested steps and tips for implementing initiatives for improving child health care quality from the CMS-funded national evaluation of the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) Quality Demonstration Grant Program. This guide focuses on the stakeholder engagement efforts inGeorgia, Idaho, and Massachusetts, and is designed to help State officials and other program administrators engage and partner with stakeholders in their own child health care quality improvement initiatives. It provides a five-step approach to engaging stakeholders, breaking down each step into smaller tasks with key points and resources to consider throughout the process.

Top of Page

Journal Articles

The national evaluation team is producing several journal articles that synthesize findings from several States and address topics of interest to the community of pediatric health services researchers.

Nine States' Use of Learning Collaborative to Improve Children's Health Care Quality in Medicaid and CHIP

. This article in the November 2013 Academic Pediatrics supplement on quality improvement examines how nine CHIPRA quality demonstration States are using learning collaboratives to improve health care quality for children. The various approaches, goals, and challenges described in the article offer lessons that other States may find useful in creating their own learning collaboratives.

Top of Page

Presentations and Webinars

Presentation from the CMS Medicaid and CHIP Quality Conference, June 2012. On June 15, 2012, Henry Ireys presented an update of the national evaluation activities to the CHIPRA quality demonstration States at the second annual CMS Medicaid and CHIP Quality Conference in Baltimore, MD. The presentation provided updates on the national evaluation team's data collection activities, early observations from site visits, Web page updates, and next steps. The slide deck is available here and as a PDF file (229 KB;

).

Top of Page

Additional Resources

CMS Web site about the CHIPRA Quality Demonstration Grant Program. In February 2010, the Centers for Medicare & Medicaid Services (CMS) awarded 10 grants, funding 18 States, to improve health care quality and delivery systems for children enrolled in Medicaid and the Children's Health Insurance Program (CHIP). CMS provides overviews of each demonstration State's funding and projects on InsureKidsNow.gov.
CHIPRA Children's Health Care Quality Measurement and Improvement Activities. This Web page, hosted on AHRQ's Web site, provides information on the following activities: (1) identifying an initial core set of children's health care quality measures for voluntary use by Medicaid and CHIP programs, (2) implementing the CHIPRA Pediatric Quality Measures Program using grants and contracts, and (3) evaluating CMS's Quality Demonstration project awards and creating a Model Children's Electronic Health Record Format.

Please note: This Web site uses the term "national evaluation" to distinguish this evaluation of the entire demonstration program from evaluations commissioned or undertaken by grantees. The word "national" should not be interpreted to mean that findings are representative of the Nation as a whole.

Top of Page

Current as of September 2014

Internet Citation: What We Learned. September 2014. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/policymakers/chipra/demoeval/what-we-learned/index.html