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Celebrating IAP’s Second Year!

This month IAP marks its second anniversary, and celebrates the program’s growth into an active agent of transformation for state Medicaid delivery system reforms.  In July 2014, when we launched IAP, we had high hopes that states would turn to IAP to drive change and improvement in key areas that affect the health and well-being of low-income people.  This year those hopes were fully realized: IAP is now directly supporting 28 Medicaid programs – compared to 11 just one year ago -- and most of those states participate in multiple focus areas:

  • Seven states are actively building delivery system changes to Reduce Substance Use Disorders.
  • Five states are finding ways to improve care for their Medicaid Beneficiaries with Complex Care Needs & High Costs.
  • Eight states are building Medicaid Agency & Housing Agency Partnerships in an effort to improve community-based long-term services and supports.
  • Nine states are planning ways to Incentivize Quality & Outcomes for their community-based long-term services and supports.
  • Three states will, beginning in the next two months, partner with IAP to implement activities related to Incentivizing Quality & Outcomes for their community-based long-term services and supports.
  • Nine states are beginning or expanding their efforts to Promote Physical and Mental Health Integration.
  • Six states are working towards gaining access to and using Medicare-Medicaid data to improve care for their dually-eligible beneficiaries.

The benefits and learning from this work extend well beyond the 28 states that are intensive participants.  This year, all 50 states and the District of Columbia have joined at least one of the 18 IAP-hosted webinars on reducing substance use disorders and housing tenancy supports.

IAP will build on this success in and beyond 2016 by launching partnerships with two key CMCS initiatives, the Maternal and Child Infant Initiative and the Children’s Oral Health Initiative.  IAP will expand to support states in testing and implementing innovative payment and contracting approaches for maternity and children’s oral health care.  We are ecstatic to expand IAP’s portfolio in these two areas as we know these are critical issues facing all Medicaid programs.  We will share additional information on these new opportunities in future commentaries.

In addition to rolling out these new areas, we have designed additional technical support opportunities that are poised to be in full swing by the end of 2016.  In particular, we are looking forward to seeing how our state partners receive the upcoming data analytic and payment modeling & financial simulations program support since we know many Medicaid programs are grappling with these issues.

Making sure that IAP is agile and reflective of feedback from both participating and non-participating states, helps CMS move more states towards their delivery system and payment reform efforts goals. CMCS and CMMI designed IAP to continually learn from itself and ensure we are meeting Medicaid programs’ needs.  We often get questions about whether or not we will run more learning collaboratives on the same program topic once we are finished working with a group of states.  Before IAP launches work with another group of states, we will focus on sharing lessons learned to all Medicaid programs and on creating related tools that share on Medicaid.gov.  By taking time in between each program area cohort to assess the successes and lessons learned, we will ultimately improve in how IAP delivers technical support to state Medicaid programs.  In that same vein, we will also continually assess whether our four program areas remain representative of the topics where states need the most support.

We also kicked off the IAP evaluation in September 2015. Over the past several months, Abt Associates, the evaluation team, has conducted focus groups and one-on-one interviews with participating states as well as interviews with program support coaches.  Although it is too early to have definitive results from the evaluation, we do know that participating states rated the content and quality of our web-based learning series on Reducing Substance Use Disorder a 4.1 out of 5.  Further, more than half of the states participating in the high intensity learning collaborative were prompted through what they had learned though IAP to provide trainings on medication-assistance treatment; analyze utilization and outcomes for patients in residential facilities; and identify measures for monitoring outcomes.

We have also identified key elements of successful IAP participation by state Medicaid programs: (1) it takes staff time to take full advantage of participation in IAP opportunities; (2) states that get the most out of IAP come in with a clear sense of one-to-two specific areas where it can benefit from IAP; and (3) a strong committed team that includes higher-level leadership and decision-makers can get a lot from their IAP experiences.  These will be important considerations, as we develop future IAP activities for states.

We’ve also learned the importance of supporting states in accessing and working with data, whether it is Medicare, public health, social support-related, and/or quality measurement data.  States are eager for these data, but challenged by limited data resources and staff.  In order to bridge the data needs of our states, we will announce additional opportunities for states in late 2016 around Medicare-Medicaid data integration and direct data analytics support.  Finally, we have crafted a way to partner with the Office of the National Coordination for HIT on IAP so that we can leverage their expertise and experiences to support our states’ HIT/HIE needs.

Looking ahead to next year, by July 2017, we will working directly with even more states and will have rolled out a series of tools and resources for states that aren’t able to work with IAP directly.  One example of the types of tools that we are developing are easy-to-use and publicly available data analytic tools mapped to T-MSIS data.  Additional information on these tools can be found in the April 2016 IAP commentary.

Thanks to all of the states and stakeholders who have helped build IAP into its strong second year, and we look forward to continuing to partner with you to build strong systems of care for the 72 million Americans Medicaid serves.

IAP Commentary
Tim Hill, Deputy Director, CMCS and Karen LLanos, Director, Medicaid IAP
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Collections: IAP Commentary