The CMS will give 17 states nearly $200 million over the next seven years to combat opioid misuse among expectant mothers and improve care for children impacted by the crisis.
The agency on Thursday announced Colorado, Indiana, Louisiana, Maine, Maryland, Missouri, New Hampshire, Tennessee, Texas and West Virginia will be the first recipients of $50 million in total grant awards over the next five years through the CMS' Maternal Opioid Misuse model.
The agency launched the program through the Center for Medicare and Medicaid Innovation in October 2018 to address fragmented care delivery among pregnant and postpartum Medicaid beneficiaries with opioid use disorder.
Under the model, the CMS will fund states' development of coordinated and integrated care-delivery approaches to meet beneficiaries' physical and behavioral health needs.
The program is meant to improve care quality and reduce health expenses related to maternal substance use, which has become more prevalent over the past two decades. The Centers for Disease Control and Prevention found rates of opioid use disorder among mothers giving birth more than quadrupled between 1999 and 2014, going from 1.5 cases per 1,000 delivery hospitalizations to 6.5.
Pregnant and postpartum women using opioids have higher risks of birth complications. It also can affect their children's health outcomes, such as low birth weight and neonatal abstinence syndrome. The CMS estimates maternal substance use results in $1.5 billion in annual hospital charges, most of which are paid by Medicaid.
The MOM model is one of two CMS programs addressing how opioid abuse affects mothers and children.
The agency on Thursday also said it had entered cooperative agreements with Connecticut, Illinois, New Jersey, New York, North Carolina, Ohio and Oregon to fund nearly $126 million over the next seven years to launch the Integrated Care for Kids program.
Those states must create alternative payment models that promote coordinating physical and behavioral health services for Medicaid beneficiaries under age 21 as well as individuals covered under the Children's Health Insurance Program and their caregivers.
"The MOM and InCK Models are a unique opportunity for healthcare providers to improve care for mothers and infants affected by the opioid crisis," HHS Secretary Alex Azar said in a statement. "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."
Both models are expected to begin in January. Full implementation of the MOM model is expected to start in year two of the program while participants in the InCK program are not expected to begin implementation until year three.
