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IAP Program Priority Area Work Plans

The three program priority areas that we announced at the end of 2014, in addition to substance use disorder, are taking root. IAP provides states with targeted program support, tools, and technical resources for: (1) Medicaid beneficiaries with complex needs and high costs; (2) community integration/long-term services and supports; (3) and physical/mental health integration. CMCS selected these program areas for IAP based on feedback from our state partners and stakeholders. These areas also represent ways where CMCS can support delivery reform efforts in Medicaid to improve how care is delivered, paid for, and measured. 

Since selecting the additional program areas, we have met with states and stakeholders, applied lessons learned from our early Substance Use Disorder (SUD) work with states, and begun to develop work plans for of the next three areas. In this commentary, we’ll provide you with a status on our Substance Use Disorder work; share ways that IAP can support ongoing efforts related to improving care for beneficiaries with complex needs and high costs; and end with a brief overview our feedback loop with state Medicaid agencies and key stakeholders about the Medicaid IAP.

  • Substance Use Disorders (SUD): Since January 2015, we have been working with seven states as part of our High Intensity Learning Collaborative. Based on discussions with states and the technical support needs they identified, IAP designed a 12-month program to support states in developing policy and infrastructure changes needed to improve the care and outcomes for individuals with SUDs. We now offer one-on-one state-specific technical support in addition to monthly group-based learning sessions reflecting rapid cycle feedback from participating states. Additionally, we brought these seven states together in May 2015 for deep-dives into key topics such as: innovative data analytic structures; best practices and strategies to support medication-assisted treatment; and state experiences implementing peer recovery models and transitions across levels of care.

    Other interested states can join our SUD IAP work through “Targeted Learning Opportunities” (TLO), a web-based, state-to-state learning series designed to support states in developing strategies for improving their SUD systems. Each TLO is organized around a different topic, and each is composed of one-to-four web-based sessions. TLO topics include data analytics, integration of primary care and SUD services, benefit design, payment reform, performance metrics, and managed care contracting. Additional information on how to participate in this learning series is outlined on our IAP SUD webpage.
  • Medicaid Beneficiaries with Complex Needs & High Costs: Our next program priority area to launch is focused on supporting states’ ongoing efforts to improve care for Medicaid beneficiaries with complex needs and high costs. We will offer targeted program support for up to ten states based on their state-specific goals related to: improving capacity for data collection and analytics; and the development and/or operationalization of payment and/or contracting approaches. On June 29, 2015 2:00 pm EDT, we will hold an informational webinar to discuss the program support available, garner feedback, and answer questions. As we did in our SUD work, we will use an iterative process to finalize the types of program support we offer. Additional information for interested states, include: an Expression of Interest Form (DOCX, 45.1 KB), Program Support Overview (PDF, 373.63 KB), and State Selection Factors (PDF, 287.92 KB).
  • Medicare-Medicaid Data Integration Support: During our listening sessions with states, we heard clearly that Medicare-Medicaid data integration can be a challenge. Partnering with CMS’s Medicare-Medicaid Coordination Office, we are pleased to offer up to six states a year access to data integration services to support integrated care for Medicare-Medicaid enrollees. This one-on-one technical support is designed to help states address the overarching challenge of successfully integrating Medicare and Medicaid data from a multitude of sources. Interested states are asked to submit an MMDI Expression of Interest Form (PDF, 44.9 KB).
  • Creating a continuous feedback loop: Feedback from states and experts continue to shape our approach to IAP. For all four of our program priority areas, we collaborated with NAMD to convene small group of state representatives via conference call to share initial feedback and reactions to our proposed technical assistance approaches. Recently, we also had the opportunity to benefit from expert feedback provided by a panel the Commonwealth Fund sponsored related to Medicaid Beneficiaries with Complex Needs and High Costs (BCN). Much of what the panel shared related to their experiences with implementing or designing BCN programs aligned with how we have designed the BCN IAP opportunity. In addition, the Milbank Fund convened a panel of state representatives to support us in further understanding how best to design and implement IAP opportunities to meet states’ needs. IAP is only as successful as its ability to meet states’ needs, so we value and look forward to continuing our work with states and partners such as the Commonwealth Fund and the Milbank Fund.

In order to create a stronger feedback loop, we will be posting these types of updates more regularly. In addition, states interested in better understanding IAP and potential opportunities, should contact me at Karen.llanos@cms.hhs.gov.

IAP Commentary
Karen LLanos, Director, Medicaid IAP
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