The Centers for Disease Control and Prevention’s (CDC) 6|18 Initiative: Accelerating Evidence into Action is bringing together public and private health care payers, purchasers, and providers to improve health and control health care costs. This innovative effort aims to link proven prevention activities to health coverage and delivery with a focus on six high-burden, high-cost health conditions — tobacco use, high blood pressure, inappropriate antibiotic use, asthma, unintended pregnancies, and diabetes. The “18” refers to a set of evidence-based interventions that address the six conditions.

From 2016 through 2023, the Center for Health Care Strategies (CHCS), with support from the Robert Wood Johnson Foundation, worked with the CDC to help inform state Medicaid and public health agency implementation of 6|18 strategies. Through the initiative, CHCS supported 40 states, local jurisdictions, and territories across the U.S. in adopting proven prevention strategies by enhancing benefits related to high-opportunity health conditions. Participating Medicaid and public health teams benefited from targeted technical assistance, peer-to-peer information exchange, and an annual in-person convening.

  • Year I (2016-2017) supported Colorado, Georgia, Louisiana, Massachusetts, Michigan, Minnesota, New York, Rhode Island, and South Carolina.
  • Year II (2017-2018) supported Alaska, Maryland, Nevada, North Carolina, Texas, Utah, as well as the District of Columbia and Los Angeles County.
  • Year III (2018-2019) supported Arkansas, California, Connecticut, Indiana, Kansas, Kentucky, Missouri, Montana, Nebraska, New Hampshire, New Jersey, Pennsylvania, Rhode Island, South Dakota, Tennessee, Virginia, Wyoming, and the Commonwealth of the Northern Mariana Islands.
  • Year IV (2019-2020) supported Colorado, Connecticut, Illinois, Kansas, Kentucky, Michigan, Missouri, Nebraska, Nevada, New Mexico, North Carolina, North Dakota, Oklahoma, Texas, Virginia, Wyoming, the Commonwealth of Northern Mariana Islands, Guam, and the U.S. Virgin Islands.

After 2020, CHCS continued to support CDC’s efforts to advance 6|18 implementation efforts by providing on-going communications and resource supports to states and territories that participated in the initiative.

To read more about state and territory interventions undertaken as part of the 6|18 Initiative — including spotlights on select state activities — visit the Implementing CDC’s 6|18 Initiative: A Resource Center.


CHCS is partnering with the Centers for Disease Control and Prevention (CDC) on CDC’s 6|18 initiative. CDC does not endorse any particular product, service, or enterprise. Views expressed in related products do not necessarily reflect those of CDC, Health and Human Services.