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The 6|18 Initiative Case Study: Capitalizing on Partners' Unique Skills and Strengths
This document discusses a collaboration between Medicaid agencies and public health departments called the 6|18 Initiative. The initiative aims to improve health outcomes and lower costs for six high-burden health conditions using eighteen evidence-based interventions. Through the initiative, Medicaid agencies utilized policy levers to improve coverage and promote service uptake, while public health departments contributed disease-specific expertise, helped translate evidence into data, and developed awareness campaigns. Key factors in the successful collaboration included early leadership buy-in, a joint work plan, and monthly coordination calls between the partners.
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The 6|18 Initiative Case Study: Capitalizing on Partners' Unique Skills and Strengths
- 1. Advancing innovations inhealth care delivery for low-income Americans www.chcs.org | @CHCShealth The 6|18 Initiative Case Study: Capitalizing on Partners’ Unique Skills and Strengths 2017 Practical Playbook National Meeting June 2, 2017 Maia Crawford, CHCS Made possible by the Robert Wood Johnson Foundation
- 2. The 6|18Initiative » Background, objectives and accomplishments » The Medicaid-Public Health partnership Group Discussion Sample Scenario 2 Agenda
- 3. 3 About the Centerfor Health Care Strategies A non-profit policy center dedicated to improving the health of low-income Americans
- 4. 4 Select CHCS Initiatives Affinity Group for U.S. Charity Care Programs Ensuring Health Coverage and Access for Justice-Involved Individuals Advancing the CDC’s 6|18 Initiative: State Medicaid & Public Health Collaboration Medicaid Accountable Care Organization Learning Collaborative State Innovation Model Technical Assistance Advancing Trauma- Informed Care Complex Care Innovation Lab Promoting Youth Substance Use Disorder Prevention Strategies in Medicaid Transforming Complex Care Medicaid Leadership Institute Medicaid Academies State Oral Health Leadership Institute Accessto Coverage andServices DeliverySystem andPayment Reform Servicesfor Peoplewith ComplexNeeds Leadership andCapacity
- 5. Promoteadoptionofevidence-basedinterventionsin collaborationwithhealthcarepurchasers,payers,andproviders 5 The 6|18 Initiative High-burden healthconditions 6 18Evidence-based interventions that improve healthand save money CDC.gov/sixeighteen Hester, J. A., J. Auerbach, L. Seeff, J. Wheaton, K. Brusuelas, and C. Singleton 2015. CDC’s 6|18 Initiative: Accelerating evidence into action. National Academy of Medicine, Washington, DC. http://nam.edu/wp-content/uploads/2016/02/CDCs-618-Initiative-Accelerating-Evidence-into-Action.pdf |
- 6. Improve healthand control health care costs using specific evidence- based interventions Establish sustainable partnerships between public health and health care purchasers, health plans, and providers 6 6|18 Initiative Goals
- 7. High-burden Costly Preventable Scalable Purchasers and payers 7 Six High-Burden Health Conditions High- burden Costly Preventable Scalable Purchasers and payers
- 8.
- 9. 9 Utah Texas North Carolina Nevada Alaska Colorado Georgia New York Map of 6|18Participants Maryland District of Columbia Michigan Louisiana South Carolina Massachusetts Rhode Island KEY Cohort 2 Cohort 1 Minnesota Los Angeles County, California
- 10. Baseline coverageand utilization assessment State Plan Amendments to enhance Medicaid benefits Changes in billing Managed care organization contractual negotiations Payment pilots New scope of practice legislative authority Provider and member education and outreach 10 Examples of 6|18 Accomplishments
- 11. The Medicaid-Public HealthPartnership: Complementary Skills Medicaid Authority over benefits and coverage Expertise in health care payment and delivery Establish health quality goals Collaborate with federal/state policymakers, and health plans Access to and analysis of state/federal data Public Health Disease-specific expertise On-the-ground knowledge of access and utilization barriers Population health focus Expertise in intervention design and implementation Experience with knowledge dissemination and provider training 11
- 12. The Medicaid-Public HealthPartnership: Complementary Activities Medicaid Utilized available policy levers to improve coverage and promote increased uptake of services Engaged with Medicaid managed care plans to enhance benefits Developed a business case for chosen interventions Public Health Contributed condition- specific subject expertise Translated epidemiologic evidence into data Developed awareness campaigns targeting providers and patients Promoted linkages with community services 12
- 13. Early leadershipbuy-in from both agencies In-person kick-off convening Concrete and well-defined interventions Creation of a joint work plan with collaboratively developed goals and activities Monthly calls Access to a common set of subject matter experts and technical assistance opportunities 13 Project Components that Facilitated Collaboration
- 14. Can youshare an example of a project in which different partners contributed unique skills or expertise that led to a positive end result? What strategies have you found effective at bringing together diverse partners and harnessing their respective abilities or knowledge? What challenges have you encountered in working with partners from different sectors or backgrounds? How did you overcome “cultural” or language differences across diverse partners? What lessons or takeaways from the 6|18 Initiative might translate to efforts to enhance public health-primary care collaboration? 14 Group Discussion
- 15. Primary care providersfrom a children’s hospital and a local public health department seek to collaboratively develop a pediatric asthma home visiting and trigger remediation program. »What skills, resources and expertise would primary care bring to the partnership? What about public health? »What recommendations would you make to ensure that both partners were able to define distinct yet complementary roles for themselves? 15 Sample Scenario
- 16. 16 For more information,contact: Maia Crawford Senior Program Officer Center for Health Care Strategies mcrawford@chcs.org (609) 528-8400
- 17. Visit CHCS.org to… Download practical resources to improve the quality and cost- effectiveness of Medicaid services Learn about cutting-edge effortsto improve care for Medicaid’s highest- need, highest-cost beneficiaries Subscribe toCHCS e-mail, blog and social media updates to learn about new programs and resources Followuson Twitter @CHCShealth 17
Editor's Notes
- #6 CDC has developed the 6|18 Initiative to promote adoption by health care purchasers, payers, and providers of evidence-based interventions to improve health and control costs in the short term – in less than 5 years. The name “6|18” comes from the initial focus on 6 high-burden high-cost health conditions and 18 evidence-based interventions that can improve health and control costs.
- #7 The initiative goals are as follows: To improve health and control health care costs using specific evidence-based interventions and To establish sustainable links between public health and health care purchasers, payers, and providers as partners in population health improvement
- #8 The 6 in 6|18 represents the 6 initial health conditions, including: Tobacco Use, High Blood Pressure, Health Care-Associated Infections, Asthma, Unintended Pregnancies, and Diabetes. These conditions were selected because they meet the following criteria: They affect large numbers of people They are associated with high health care costs Evidence-based interventions are available to prevent or control these conditions in a short time horizon (less than 5 years) The evidence-based interventions can be implemented by the health care sector - health care purchasers, health plans, and providers.
- #10 Yellow = Phase I States: CO, GA, LA, MA, MI, MN, NY, RI, SC Orange = Phase II States: AK, DC, MD, NC, NV, TX, UT, and LA County Also looking to engage a large city public health department and a tribal nation.