The Center for Health Care Strategies (CHCS) is the primary technical assistance provider and coordinating entity for the three states – Maryland, Georgia, and Wyoming – awarded a CHIPRA Quality Demonstration grant by the Centers for Medicare and Medicaid Services (CMS) in February 2010. The states will implement or expand the use of a Care Management Entity (CME) model to coordinate the services and supports needed by children and youth with serious behavioral health challenges involved in multiple systems and their families. The CME serves as the locus of accountability for these youth and families and is responsible for managing their care and outcomes across systems.

This webinar — fourth in the series — described CME financing issues and options, including Medicaid, noted in the first webinar in this series. Speakers presented the financing of four CME models, discussing:

  • Use of various Medicaid approaches, such as targeted case management, administrative case management, 1915(c) waivers, 1915(a) authority, and blended and braided funding approaches that include Medicaid and other system financing;
  • Financing for services that are critical to supporting CME effectiveness (e.g., peer supports, crisis services, intensive home-based services), including use of the Rehabilitation Services Option in Medicaid;
  • Payment approaches such as capitation, all-inclusive, partial and tiered case rates, 15-minute billing increments, and single payor systems for multiple funding streams;
  • CME rates, and issues related to rate-setting; and
  • Expected cost savings and offsets of the CME approach.