Children and adolescents with complex behavioral health conditions often receive fragmented care through multiple service systems, resulting in poor outcomes and unnecessarily high costs. A number of states and regions have begun to demonstrate significant cost savings and improved clinical and functional outcomes for children and youth with behavioral health issues through the use of the Care Management Entity (CME) Model. Care management entities offer a centralized vehicle for coordinating the full array of needs for children and adolescents with complex behavioral health issues.
This fact sheet, developed by the Center for Health Care Strategies (CHCS), outlines the core characteristics of this promising new approach. CHCS is the coordinating entity for a five-year, three-state Quality Demonstration Grant project funded by the Centers for Medicare & Medicaid Services through the Children’s Health Insurance Program Reauthorization Act of 2009. The multi-state grant is supporting lead-state Maryland, and partner states Georgia and Wyoming, in planning and implementing a CME approach to improve clinical and functional outcomes and reduce costs for high-utilizing Medicaid- and CHIP-enrolled children and youth with serious behavioral health challenges.