The 6|18 Initiative: Accelerating Evidence into Action NAMD Fall Conference 2017 November 8, 2017 Funded by the Robert Wood Johnson Foundation

Promote adoption of evidence-based interventions in collaboration with health care purchasers, health plans, and providers 6 18 | Evidence-based interventions that can improve health and save money High-burden health conditions INITIATIVE Improve health and control health care costs using specific evidence-based interventions and Establish sustainable links between public health and health care purchasers, payers, and providers as partners in population health improvement 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, initially, 18 evidence-based interventions that can improve health and control costs. The number of interventions may fluctuate over time. 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 Hester, J. A., J. Auerbach, L. Seeff, J. Wheaton, K. Brusuelas, and C. Singleton. CDC’s 6|18 Initiative: Accelerating Evidence into Action. National Academy of Medicine, 08 February 2016

Six High-burden Health Conditions Costly Preventable Scalable Purchasers & Payers 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. www.CDC.gov/sixeighteen

State Medicaid Agency - Public Health Department 6|18 Implementation Utah Texas North Carolina Nevada Alaska Colorado Georgia New York Maryland District of Columbia Michigan Louisiana South Carolina Massachusetts Rhode Island KEY Year 2 Year 1 Minnesota Los Angeles County, California While anyone can benefit from the 6|18 Initiative’s current set of resources (the intervention list and evidence summaries – which are publicly available on the CDC website) – CDC has also been working with CHCS (thanks to an RWJF grant), CMS, and other partners to provide more intensive technical assistance and support to a distinct set of state Medicaid-public health teams as they implement chosen interventions. This is what we’re calling the “proof of concept” for this work – with the idea being that by providing very targeted and individualized support to these state-level teams, we can better understand the needs, challenges and opportunities associated with implementing 6|18 interventions. We can then use those learnings to craft an expanded set of resources, templates and learning opportunities that would eventually be available to a much wide audience in the future. Map of 6|18 Public Payer participants. Yellow = Phase I Team , which began in Feb. 2016: CO, GA, LA, MA, MI, MN, NY, RI, SC Orange = Phase II Teams, which includes 6 states and kicked off last week in Atlanta (AK, MD, NC, NV, TX, UT) + DC, + LA COUNTY: Phase II teams were chosen though a competitive review process; interested states and localities submitted a statement of interest form, which included an indication of support from both the state’s SMD and the SHO, and a description of anticipated interventions and TA needs. Some of the Round I states have graudated from this effort and are now serving as mentor states – which others are still actively engaged in ongoing impelemtnation work and TA. Worked hard to customize the support that the CDC/CHCS team provides based on each team’s unique needs. Also looking to engage a tribal nation.