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CMS Announces New Model to Address Impact of the Opioid Crisis for Children

August 29, 2018

The Centers for Medicare & Medicaid Services (CMS) has announced a new Innovation Center state payment and local service delivery model, Integrated Care for Kids (InCK), to combat the nation’s opioid crisis.

The InCK model is aimed at reducing expenditures and improving the quality of care for children covered by Medicaid and the Children’s Health Insurance Program through prevention, early identification, and treatment of priority health concerns like behavioral health challenges and physical health needs.

Up to eight states will be awarded a maximum of $16 million each in as early as Spring of 2019 to implement the seven-year model to address these priorities through a framework of child-centered care integration across behavioral, physical, and other child providers, including:

  • Early identification and treatment of children with multiple physical, behavioral, or other health-related needs and risk factors through population-level engagement in assessment and risk stratification
  • Integrated care coordination and case management across physical health, behavioral health, and other local service providers for children with health needs impacting their functioning in their schools, communities, and homes
  • Development of state-specific alternative payment models to align payment with care quality and supporting accountability for improved child health outcomes and long-term health system sustainability

The CMS Innovation Center anticipates releasing a detailed Notice of Funding Opportunity during the fall with additional details on how state Medicaid agencies and local health and community-based organizations can apply to participate in the model.

Pennsylvania’s hospital community remains committed to taking a leading role to address the opioid crisis and continue to support the commonwealth’s work to address the opioid crisis. Hospitals play crucial roles in preventing overdoses and treating substance use disorder and continue to work to turn the tide on the epidemic.

Pennsylvania’s hospitals have been, among other things:

  • Collaborating with government, county organizations, and other health care providers to organize warm handoff protocols, to help overdose survivors connect to treatment options
  • Supporting programs to help mothers with substance use disorder and their babies suffering from neonatal abstinence syndrome
  • Implementing safe opioid prescription guidelines and monitoring patients’ prescription pain medication use via the Pennsylvania Drug Monitoring Database
  • Facilitating education and access to overdose prevention resources

More information about the InCK model is available on the CMS website. For information about HAP’s state and federal opioid response efforts, contact Jennifer Jordan, HAP’s vice president, regulatory advocacy, or Laura Stevens Kent, HAP’s vice president, federal advocacy.

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