Say Ahhh! readers are familiar with one of our biggest concerns about health care payment and delivery system reforms: Kids, relatively inexpensive to begin with, are often overlooked and rarely the explicit focus. It’s hard to make improvements to health care for children and youth without payment or delivery system changes. And testing new reforms requires funding. Last year, CMS signaled intent to fund two new projects focused on children and youth and pregnant/postpartum mothers in Medicaid. As Tricia Brooks correctly noted at the time: This is a really big deal.
Well wait no more! The CMS Innovation Center released two long-awaited notice of funding opportunities to test new health care delivery and payment approaches for children and mothers: the Integrated Care for Kids (InCK) and the Maternal Opioid Misuse (MOM) models. (With acronyms InCK and MOM, there’s likely a joke somewhere here about Mom tattoos, but I’m not that clever…). Both serve as an opportunity to test new ways to more effectively meet the needs of children and their parents affected by the opioid epidemic.
MOM is more narrowly focused on pregnant and postpartum mothers in Medicaid struggling with opioid addiction, alongside their infants. InCK, while promoted as another tool to combat opioid addiction, is more broadly aimed at testing ways to more effectively address the full health care needs—including behavioral health— of children under age 21 in Medicaid and CHIP.
This helpful two-pager from CMS provides a side-by-side overview of the two opportunities, summarized below.
|InCK model||MOM model|
|Who can apply?||State Medicaid Agency or local lead organization (with Medicaid support)||State Medicaid agency in partnership with at least one “care-delivery partner”|
|Focus population||All Medicaid and CHIP beneficiaries, pre-natal to age 21||Pregnant and postpartum Medicaid beneficiaries with opioid use disorder (OUD) and their infants|
|Goals||Reduce expenditures and improve the quality of care for children in Medicaid and CHIP through prevention, early identification, and treatment of behavioral and physical health needs.||Address fragmentation in the care of pregnant and postpartum Medicaid beneficiaries with opioid use disorder.|
|Number/range of grants||Up to 8||Up to 12|
|Funding amount||$14.5 million – $16 million max||$5.38 million max|
|Timeline||7 years, implementation starts Year 3||5 years, care delivery begins year 2|
|Applications due||June 19, 2019 (optional letter of intent due March 11)||May 6, 2019|
|Where can I learn more?||Webinar: 2/19 at 2:30pm EST
InCK Marks website designed to support applicants
|Webinar: 2/21 at 2pm EST|