Program Area Updates

Over the past 12 months, the Medicaid Innovation Accelerator Program (IAP) has worked directly with 15 states and has reached over 40 states through its national, virtual learning opportunities. However, in many ways IAP’s work with states is just beginning in its four program areas:

• Reducing Substance Use Disorders (SUD)
• Improving Care for Medicaid Beneficiaries with Complex Needs and High Costs (BCN)
• Promoting Community Integration in Long-Term Services and Supports (CI-LTSS)
• Supporting Physical and Mental Health Integration (PMH Integration)

Each of these program areas were phased in at different times over the past year. For this month’s commentary, we’ll share a brief update on where each program area is and how the IAP program teams are working with state Medicaid agencies in each of these areas. 

• Reducing Substance Use Disorders (SUD). After 12 months of working closely with seven states, the High Intensity Learning Collaborative (HILC) held its last in-person meeting in January to conclude formal collaborative activities. However, the IAP will continue to work with many of the HILC states on implementing the coverage, payment and programmatic initiatives they designed to reduce SUDs. In addition, the IAP will support these and other states with strategizing about the development of Medicaid SUD 1115 waiver proposals. The program team also developed a four-part, national dissemination webinar series highlighting the work of the HILC states and the topics addressed during the HILC. The kick off webinar will feature several of the HILC states and is scheduled for early April 2016. Be on the lookout for additional details on how to register for this webinar.
  
  We know many of our state partners have joined us each month for the Targeted Learning Opportunities (TLO), our webinar learning series on SUD-related issues. There are only three TLOs left in the series. The next TLO webinar is March 14th on SUD services for neonatal abstinence syndrome and the last two webinars are on SUD value-based purchasing approaches and quality measurement, respectively.
• Improving Care for Medicaid Beneficiaries with Complex Needs and High Costs (BCN). This program area is well underway supporting five states with designing and implementing delivery systems reforms for their BCNs. For the purposes of this IAP program, each participating state defined their BCNs population. For example, one state is expanding substance use services for its target BCN population and another state seeks to build a health home for beneficiaries with chronic conditions. To complement the five states’ work, the program team hosts monthly webinars on topics such as identifying and targeting BCNs. This month we focused on critical dataset identification and data sharing. Over the next few months, we will address topics such as alternative payment strategies and monitoring/quality measurement approaches. The program team is also in the midst of planning an in-person meeting for its five states in early April.
• Promoting Community Integration in LTSS. To meet states’ multiple technical support needs in the area of community-based LTSS, IAP designed this program area a bit differently than the other program areas. There are two components with two tracks each:
  1. Medicaid Housing-Related Services and Partnerships (HRSP)
     • Supporting Housing Tenancy web-based learning series track and a more intensive State Medicaid-Housing Agency Partnership track
  2. Incentivizing Quality and Outcomes (IQO)
     • Planning an IQO Strategy track and Implementation of an IQO Strategy track

• The IAP had an enormous state response to the Medicaid Housing-Related Services and Partnerships component. The program team received over 25 states’ expression of interest forms, thereby reinforcing the importance of this issue for our state Medicaid partners. To facilitate housing relationships in these states, the IAP program team is partnering with the U.S. Interagency Council on Homelessness, U.S. Department of Housing & Urban Development, Office of The Assistant Secretary for Planning and Evaluation, and the Substance Abuse & Mental Health Administration. IAP held the first Supporting Housing Tenancy webinar on February 24th with 27 states participating. In addition, we announced that we will be working with California, Connecticut, Hawaii, Illinois, Kentucky, Nevada, New Jersey, and Oregon, in the intensive, six-month State Medicaid-Housing Agency Partnership track. Consistent with statute, CMS does not provide Federal Financial Participation for room and board in home and community-based services, but can assist states with coverage of certain housing-related activities and services.
  
  Since the IQO component does not begin until April, the program team is currently holding office hours with states that expressed interest. Once states are selected for this component, we will share additional information.

• Supporting Physical/Mental Health Integration. We announced this program area in December 2015, so there is not too much to share just yet. The program team is currently reviewing expression of interest forms and holding office hours with interested states. Program activities with selected states begin in late March/early April. This program area will focus on supporting states’ spread of effective physical/mental health integration models and payment approaches through individualized coaching and affinity group activities.

We hope you find this snapshot of where we are with each of the program areas helpful. For next month’s commentary, we will take a deeper dive into our Reducing Substance Use Disorders program area.