MANAGING HIGH-RISK POPULATIONS

Centers for Disease Control and Prevention’s (CDC) 6/18 Initiative

The Centers for Disease Control and Prevention (CDC), through partnerships with health care purchasers, payers, and providers, aims to improve health and control costs through the 6/18 initiative.

FOCUS:

The 6/18 initiative targets six common and high-cost health conditions – tobacco use, high blood pressure, health care-associated infections, asthma, unintended pregnancies, and diabetes – using 18 proven interventions.

CDC partners with 15 state Medicaid programs and their respective state public health departments to implement and improve the 6/18 interventions in their populations served. States responded on their experience and how it has positively impacted their states.

One such state, South Carolina, worked on enhancing tobacco cessation benefits in their Medicaid program. They worked to include several payer interventions suggested by the 6/18 initiative, including:

  • Expanding access to evidence-based tobacco cessation treatments, including individual, group and telephone counseling and FDA-approved cessation medications.
  • Removing barriers that impede access to covered cessation treatments, such as cost-sharing and prior authorization.
  • Promoting the increased use of covered treatment benefits by tobacco users.

South Carolina’s Medicaid agency partnered with DHEC, the state’s public health agency, who assisted in the 6/18 initiative through leveraging surveillance data and reinforcing South Carolina’s tobacco quitline for free counseling with skilled behavioral health coaches. Beginning July 1, 2017, SCHDDS made treatment options available for all full-benefit Medicaid members including all seven FDA-approved medications with no prior authorizations, co-pays, and included medically appropriate combination therapies.