Three years ago, the Center for Medicaid and CHIP Services (CMCS) launched a collaboration with the Center for Medicare-Medicaid Innovation (CMMI) entitled the Medicaid Innovation Accelerator Program (IAP). Our Center created IAP to ensure that Medicaid had an imprint in the delivery system reform efforts that were going on across the country and in acknowledgement that were already many Medicaid-driven delivery system reforms underway to leverage. As the Deputy Director of CMCS, I am so pleased to have a resource like IAP available to our state partners so that we can continue to support even more states as they design and implement their delivery system reforms. In this anniversary commentary, I provide a brief overview of states we’ve been able to work with through IAP; share examples of how IAP is supporting state innovation; and announce the latest group of states with whom IAP is collaborating.
IAP’s aim is to support Medicaid programs in meeting their delivery system reforms goals. In each year that IAP has been operational, we have reached a broader group of states:
- 31 states, the District of Columbia (DC), and three Territories have participated in direct technical support.
- All 50 states and DC have participated in at least one national webinar.
- The majority of IAP states are participating in more than one IAP activity. Eighteen states and DC are participating in two or more IAP opportunities.
It is exciting to be reaching so many states and supporting their efforts to build internal capacity to pursue delivery system and payment reform activities related to our target program areas of: reducing substance use disorders, promoting community integration in long-term services and supports; improving care for beneficiaries with complex care needs; and supporting states’ efforts around physical/mental health integration. We see IAP’s work with states as a prime example of how CMS is supporting states to drive innovative approaches that improve the quality of care, accessibility, and affordability.
Further illustrating this point, are the two newly launched functional areas of: (1) Value-Based Payment and Financial Simulations and (2) Data Analytics. These two functional areas are designed to provide tailored, one-on-one technical support to selected states for up to 12 months. The Value-based Payment and Financial Simulations (VBPFS) functional area focuses on individualized technical support to states in designing, developing, or implementing value-based payment approaches (i.e. payment models that range from rewarding for performance in fee-for-service to capitation, including alternative payment models and comprehensive population-based payments). In June, IAP began working with the following group of states: District of Columbia; Idaho; Illinois; Kentucky; Massachusetts; Minnesota; New Hampshire; New Jersey; Oregon; and Virginia.
In order to drive more innovative approaches to improve quality, accessibility, and affordability, IAP launched additional VBPFS technical support opportunities targeting two Medicaid-specific populations: maternal/infant and children’s oral health. IAP selected three states (District of Columbia, Michigan, and New Hampshire) to receive up to two years of technical support in selecting, designing, and testing value-based payment approaches focused on sustaining children’s oral health care delivery models. Similarly, IAP recently selected five states (Colorado, Maine, Mississippi, Nevada, and Oregon) to receive technical support related to selecting, designing, and testing value-based payment approaches that sustain care delivery models demonstrating improvement in maternal and infant health outcomes. These latest VBP efforts build off of two successful CMCS initiatives, the Children’s Oral Health Initiative and the Maternal and Infant Health Initiative that work with states to address quality-related aspects of care.
IAP recently kicked off targeted technical support with states around data analytics. For many states, a critical barrier to achieving Medicaid delivery system reform is data analytic capacity. For this new technical support opportunity, IAP is working with nine states and two territories (Alabama, Guam & Commonwealth of the Northern Marina Islands, Mississippi, Nebraska, New Hampshire, New Jersey, North Dakota, Pennsylvania, Washington, and West Virginia) by providing targeted technical support in building and strengthening their data analytic capacity as they design and implement delivery system reforms. These states are working with the IAP data analytic team in areas such as: designing an analytic strategy; improving programmatic decision-making; building and executing statistical models; planning for the integration of non-Medicare data; and developing transfer protocols for sharing data.
Finally, I am pleased to announce a second round of IAP’s State Medicaid-Housing Agency Partnerships track. The goals of this track are to: 1. to develop public and private partnerships between the Medicaid and housing systems; and 2. to support states in the creation of detailed action plans that foster additional community living opportunities for Medicaid beneficiaries. IAP will be working with the following eight states from August 2017 through April 2018: Alaska, Massachusetts, Michigan, Minnesota, Nebraska, Texas, Utah, and Virginia.
In looking back over the past year, it is clear that IAP is hitting its stride. With each cohort of states, we learn more about the type and nature of technical support that our state partners need in order to meet their Medicaid delivery system reform goals. Over the next year, IAP will to continue to provide states with technical support and tools related to data analytics, quality measurement, performance improvement, and value-based payment modeling and financial simulations.
I look forward to continuing to support states’ Medicaid delivery system reform efforts and to sharing those lessons learned with you through national webinars and other learning opportunities.