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.

1. Advancing innovations in health 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|18 Initiative
» Background, objectives and accomplishments
» The Medicaid-Public Health partnership
 Group Discussion
 Sample Scenario
2
Agenda

3. 3
About the Center for 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
health conditions
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 health and
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. 8
Eighteen Evidence-Based Interventions

9. 9
Utah
Texas
North
Carolina
Nevada
Alaska
Colorado
Georgia
New
York
Map of 6|18 Participants
Maryland
District of Columbia
Michigan
Louisiana
South Carolina
Massachusetts
Rhode Island
KEY
Cohort 2
Cohort 1
Minnesota
Los Angeles County,
California

10.  Baseline coverage and 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 Health Partnership:
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
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12. The Medicaid-Public Health Partnership:
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
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13.  Early leadership buy-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 you share 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 providers from 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?
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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
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about new programs and resources
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