Advancing innovations in health care delivery for low-income Americans www.chcs.org | @CHCShealth Catalyzing Medicaid - Public Health Collaboration to Achieve Mutual Prevention Goals: Lessons from the CDC’s 6|18 Initiative October 17, 2019 Center for Health Care Strategies Centers for Disease Control and Prevention Developed with support from the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation. CHCS is partnering with the Centers for Disease Control and Prevention (CDC) on CDC’s 6|18 Initiative. CDC does not endorse any particular product, service, or enterprise.
Transcript
Advancing innovations in health care delivery for low-income Americans
www.chcs.org | @CHCShealth
Catalyzing Medicaid-Public Health Collaboration to Achieve Mutual Prevention Goals: Lessons from the CDC’s 6|18 Initiative
October 17, 2019
Center for Health Care Strategies
Centers for Disease Control and Prevention
Developed with support from the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation. CHCS is partnering with the Centers for Disease Control and Prevention (CDC) on CDC’s 6|18 Initiative. CDC does not endorse any particular product, service, or enterprise.
To submit a question online, please click the Q&A icon located at the bottom of the screen.
Answers to questions that cannot be addressed due to time constraints will be shared after the webinar.
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Questions?
www.chcs.org | @CHCShealth
Advancing innovations in health care delivery for low-income Americans
Welcome &Introductions
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Meet Today’s Presenters
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Meshie KnightRobert Wood Johnson Foundation
Kristin BrusuelasCenters for Disease Control and Prevention
Tricia McGinnisCenter for Health Care Strategies
Deirdra Stockmann Centers for Medicare & Medicaid Services
Meet Today’s Presenters
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Stephanie BatesDept. for Medicaid Services, Kentucky
Jane HybschNew Hampshire Dept. of Health and Human Services
Shilpa PatelCenter for Health Care Strategies
Connie WhiteKentucky Dept. for Public Health
Teresa BrownNew Hampshire Dept. of Health and Human Services
Donna AsburyNew Hampshire Dept. of Health and Human Services
Introduction and Overview of 6|18 Accomplishments
The Value of 6|18: Perspectives from CDC and CMS
Medicaid-Public Health Partnerships to Prevent Type 2 Diabetes and Reduce Tobacco Use
» New Hampshire
» Kentucky
New 6|18 Technical Assistance Opportunity
» Timeline and selection process
Q&A
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Agenda
Building a Culture of Health
in America
Meshie KnightProgram Officer
@meshieknight
What is CDC’s 6|18 Initiative?
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Promoting the adoption of evidence-based interventions in collaboration with health care purchasers, payers, and providers
High-burdenhealth conditions 6 18 Evidence-based
interventions that improve health and control costs
CDC.gov/sixeighteen
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Improve health and control costs using specific evidence-based interventions
Establish sustainable cross-sector partnerships between public health and health care purchasers, health plans, and providers to address shared health priorities
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CDC’s 6|18 Initiative Goals
Aligns with quality improvement goals
Potential to accelerate the impact of value-based payment reform efforts
Promotes effective and results-driven cross-sector collaboration
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Why Adopt the CDC’s 6|18 Initiative?
“6|18 fostered communication and collaboration so that we
each know what each other is doing.”
“No longer do we think reimbursement is only a
Medicaid issue.”
- State Medicaid - State Public Health
Baseline coverage and utilization assessment (e.g. MCO Surveys)
State Plan Amendments to enhance Medicaid benefits
Changes in billing
MCO contractual negotiations
Payment pilots
New scope of practice legislative authority
Provider and member education and outreach
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Examples of 6|18 State Accomplishments
Public Health Medicaid
Contributed condition-specific subject expertise
Developed a business case for chosen interventions
Translated epidemiologic evidence into benefits for coverage
Utilized available policy levers to improve coverage and promote increased uptake of services
Developed awareness campaigns targeting providers and patients
Engaged with Medicaid managed care plans to enhance benefits
Promoted linkages with community services
Engaged providers and members
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Accomplishments: Building Sustainable Partnerships & Leveraging Complementary Roles
Excerpted from: Seeff LC, McGinnis T, Heishman H. CDC's 6|18 Initiative: A Cross-Sector Approach to Translating Evidence Into Practice Journal of Public Health Management and Practice: February 22, 2018 - Volume Publish Ahead of Print - Issue -p doi: 10.1097/PHH.0000000000000782. Practice Full Report: PDF Only
Advancing innovations in health care delivery for low-income Americans
The Value of 6|18: Perspectives from CDC and CMS
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Deidra Stockmann,Technical Director for Quality ImprovementCenters for Medicare & Medicaid
Kristin Brusuelas,Senior Policy AdvisorCenters for Disease Control & Prevention
www.chcs.org | @CHCShealth
Advancing innovations in health care delivery for low-income Americans
Medicaid-Public Health Partnerships to Prevent Type 2 Diabetes and Reduce Tobacco Use
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State of New Hampshire Department of Health and Human Services
Office of Medicaid Services and Division of Public Health ServicesTobacco Prevention and Cessation Programs
October 17, 2019
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State of New Hampshire
Department of Health and Human Services
1. Introduction
2. Strategies
3. Key Activities
4. Accomplishments
5. Next Steps
176l18 Initiative: Reducing Tobacco Use
NH Department of Health and Human Services
Division of Medicaid Services (DMS)• Jane Hybsch, RN BSN MHA, Administrator, Medicaid Medical Services Unit• Henry Lipman, MBA, Medicaid Director
Division of Public Health Services(DPHS) • Sai Cherala, MD, MPH, Bureau Chief Population Health and Community Services• Donna Asbury, MPH, Tobacco Prevention and Cessation Programs (TPCP) Administrator• Teresa Brown, BS, TTS, Cessation Program Manager
6l18 Goal: Reduce tobacco use among NH Medicaid population using strategies to improve accessibility to cessation medication(s) and reduce barriers.• 2017-2018 Medicaid reprocurement process for the Medicaid Managed Care Organizations.• Inter-agency workgroup focused on expanding the cessation benefit from exclusively pregnant women
to entire Medicaid population.• The inter-agency workgroup invited TPCP staff to act as subject matter experts relative to evidence
based tobacco cessation.• Application to Center for Health Care Strategies (CHCS)
Collaboration, Goal & Strategies
186l18 Initiative: Reducing Tobacco Use
Key Activities: • Created a Workplan to assess the current language and utilization of Medicaid cessation
medication benefit (Wellsense, NH Healthy Families and FFS).• Researched model contract language to place into the MCO RFP.• Reached out to NAQC Public Private Partnership workgroup, Anne DiGuilio of the American Lung
Association (ALA) and Anna Schecter of the Centers for Disease Control and Prevention (CDC).
Accomplishments:• Agreement to engage in collaboration between DMS and DPHS.• Inclusion of comprehensive, evidence-based tobacco cessation language in the Request for
Proposal process and final contract documents.• Acknowledgement of the need to review utilization of prior authorization codes prior to
removing prior authorization.
Key Activities & Accomplishments
196l18 Initiative: Reducing Tobacco Use
Key Activities:• TPCP Epidemiologist worked with the All Payors Claims Data subcontractor, the University of NH,
to determine CPT codes 99406 and 99407 utilization.• TPCP is working with NAQC Public Private Partnership workgroup, ALA (Anne DiGuilio) and CDC
(Anna Schecter).• Developing an implementation guidance document for review and input from the NH Medicaid
Team.• DMS will provide an update relative to prior authorization utilization which will assist to
determine next steps regarding prior authorization.
Next Steps:• Complete the NH Medicaid Guidance Document that will describe implementation actions that
sustain patient-centered, high-value care.• DPHS and DMS will assess readiness and document next steps relative to submitting a SPA to
enhance NH Medicaid’s cessation benefit.
Key Activities & Accomplishments
206l18 Initiative: Reducing Tobacco Use
1. We recognize that that among the 6l18 states working on reducing tobacco use, there are many different approaches.
2. A quality team approach is critical to advancing efforts to systematically reduce health care services consumption, chronic disease care and interventions, and long term care costs related to tobacco use and dependence.
Next Steps: 1. Investigate the need for a State Plan Amendment 2. Understand MCO performance measures; and 3. Share quitline performance measures (engagement, utilization, and quit status) with DMS
decision makersa. No matter how detailed you feel the requirement/benefit is, there is always a need for further
clarificationb. Provide data and education, but keep it simple and clearly stated.
Lessons Learned & Next Steps
Kentucky 6|18 Update
Year One
Stephanie Bates
Deputy Commissioner
Department for Medicaid ServicesConnie Gayle White
Deputy Commissioner
Department for Public Health
Intervention 1: SUPPORT EXISTING DIABETES EFFORTS
• Managed Care Organization Pilot
• Foster faith-based initiative of Kentucky Diabetes Network
• Support more robust billing by local health departments for DSME/S
• Continue convening DPP Coverage State Engagement Meeting (StEM) Medicaid/MCO Task Force
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Intervention 2:DEVELOP NEW DIABETES EFFORTS
• Continue newly developed chronic disease meeting between Department of Medicaid and Public Health
• Develop communication strategies for the Diabetes Bi-Annual Report
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Senate Joint Resolution 7
• A JOINT RESOLUTION directing the Department for Medicaid Services to study the potential impacts of implementing programs similar to the Kentucky Employees’ Health Plan’s Diabetes Value Benefit plan and Diabetes Prevention Program for Medicaid beneficiaries in the Commonwealth.
• Directs DMS to submit a written report of its findings to the Interim Joint Committee on Health and Welfare and Family Services.
• Signed by the Governor March 19, 2019
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www.chcs.org | @CHCShealth
Advancing innovations in health care delivery for low-income Americans
Question & Answer
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To submit a question online, please click the Q&A icon located at the bottom of the screen.
Answers to questions that cannot be addressed due to time constraints will be shared after the webinar.
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Questions?
www.chcs.org | @CHCShealth
Advancing innovations in health care delivery for low-income Americans
Learn about the New 6|18 Technical Assistance Opportunity
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Shilpa Patel, CHCS
Solicitation of state and territorial Medicaid and public health agencies to indicate interest in jointly participating in 6|18
Focus on one of the following health conditions:»Asthma »Antibiotic use »High blood pressure»Tobacco use
Receive technical assistance to select and implement interventions over 12 – 18 months
6|18 Round 4 TA Opportunity: Program Overview
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Build/enhance cross-agency partnerships
Implement concrete interventions that align with state payment reform activities and goals
Improve health and control costs using evidence-based interventions
Receive targeted technical assistance
Learn from and share experiences with other states
Benefits of State Participation
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Action plan development
Targeted technical assistance
Peer-to-peer information exchange
Access to a range of how-to tools and other resources, including a private online 6|18 Collab community
In-person convenings
Project Activities
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Calls between State team and TA team to deliver technical support and discuss progress
Participation in a private 6|18 Collab, an online community to facilitate sharing among and across teams
Peer-to-peer condition-specific calls and online discussion threads
One in-person convening per year
As needed offline state work to advance 6|18 goals
Participation in 6|18 TA assessment activities
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Anticipated Time Commitment
Statement of interest form is available at: www.618resources.chcs.org/apply
Respond to all questions directly in the Microsoft Word document
Send completed form as an email attachment to CHCS at [email protected]
Online resource center, made possible by the Robert Wood Johnson Foundation, to help Medicaid agencies and MCOs collaborate with public health departments to launch 6|18 interventions
Offers practical how-to resources, including:
6|18 in Action - Interactive map of 6|18 activities from across the country and profiles of select state activities
General resources to help stakeholders get started with 6|18 interventions
Health condition-specific resources to guide the implementation of CDC’s 6|18 Initiative strategies
www.618resources.chcs.org
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Visit CHCS’ Resource Center for Implementing CDC’s 6|18 Initiative
