CMS awards funding to combat opioid misuse among expectant mothers and improve care for children impacted by the crisis

CMS awards funding to combat opioid misuse among expectant mothers and improve care for children impacted by the crisis
Goals are to improve quality of care, increase access to treatment based on state-specific needs, and reduce expenditures

Today, the Centers for Medicare & Medicaid Services (CMS) announced ten states selected to receive funding under the Maternal Opioid Misuse (MOM) Model.  These selections are the next step in the CMS multi-pronged strategy to combat the nation’s opioid crisis and address fragmentation in the care of pregnant and postpartum Medicaid beneficiaries with opioid use disorder (OUD).  The MOM Model has the potential to improve the quality of care and reduce expenditures for pregnant and postpartum women with OUD as well as their infants, increase access to treatment, and create sustainable coverage and payment strategies that support ongoing coordination and integration of care.

CMS also issued eight cooperative agreements for the Integrated Care for Kids (InCK) Model, which will begin in early 2020 in seven states. Launching in January 2020, this seven-year model is another part of CMS’s strategy to fight the opioid crisis and address its impact on vulnerable Medicaid and Children’s Health Insurance Program (CHIP)-covered children and their caregivers. The InCK Model aims to improve child health, reduce avoidable inpatient stays and out-of-home placement, and create sustainable payment models to coordinate physical and behavioral health care with services to address health-related needs.

“The MOM and InCK Models are a unique opportunity for healthcare providers to improve care for mothers and infants affected by the opioid crisis, and the models represent another step in President Trump’s agenda to address two significant public health challenges: the opioid crisis and maternal health by providing holistic, compassionate treatment and recovery services,” said HHS Secretary Alex Azar. “The models also are aimed at promoting more coordination and integration of care to improve health for children with complex needs and drive better outcomes, and we look forward to assessing the results of our participants as they work to support some of the most vulnerable mothers, infants and children.”

By supporting the coordination of clinical care and the integration of other services critical for health, wellbeing, and recovery, the MOM Model has the potential to improve quality of care and reduce the cost of providing medical care to mothers and infants alike. As CMS’s first pediatric model, InCK supports a focus on assessing and serving the needs of the “whole child” from the prenatal stage to age 21 across multiple service systems, where risk factors for poor health outcomes may be more evident than in clinical care settings alone.

“Public health crises on the scale of the opioid epidemic call for a focused, coordinated approach on all levels of care,” said Principal Deputy Administrator Kimberly Brandt. “Unfortunately, mothers and children suffering from substance use disorders all too often receive just the opposite today – namely, care that is fragmented and ineffective. CMS is granting these funds to programs and states throughout the nation that have the ability to reverse that state of affairs. Those suffering from substance use disorders have enough on their plate without worrying about getting access to the healthcare supports they need. CMS will stop at nothing to support them in their road to recovery.” 

The MOM Model will have a five-year period of performance beginning in January 2020 with three different types of funding, totaling approximately $50,000,000. Specifically, awardees will use the funds to transition into the new model of care, and then fully implement their plan. The following 10 states have been awarded MOM Model funding: Colorado, Indiana, Louisiana, Maine, Maryland, Missouri, New Hampshire, Tennessee, Texas, and West Virginia.

InCK funding will provide Connecticut, Illinois (2 awards), New Jersey, New York, North Carolina, Ohio, and Oregon with the flexibility to design interventions for their local communities that align health care delivery with child welfare support, educational systems, housing and nutrition services, mobile crisis response services, maternal and child health systems, and other relevant service systems. By bringing together medical, behavioral, and community-based services, InCK strives to reduce fragmentation in service delivery and expand access to care for children and youth.

For additional details about the InCK Model, please click visit https://innovation.cms.gov/initiatives/integrated-care-for-kids-model/.

For additional information about the MOM Model, please visit: https://innovation.cms.gov/initiatives/maternal-opioid-misuse-model/.

For additional information about how the two models compare, please visit: https://www.cms.gov/newsroom/fact-sheets/comparing-inck-mom-models

### 

Get CMS news at cms.gov/newsroom, sign up for CMS news via email and follow CMS on Twitter CMS Administrator @SeemaCMS, @CMSgov, and @CMSgovPress.