Start: April 2016

Funder: Robert Wood Johnson Foundation


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, health care-associated infections, asthma, unintended pregnancies, and diabetes. The “18” refers to a set of evidence-based interventions that address the six conditions.

Accelerating Evidence into Action in Medicaid and Public Health

In 2016, the Center for Health Care Strategies (CHCS), with support from the Robert Wood Johnson Foundation, began working with the CDC, as well as the Centers for Medicare & Medicaid Services (CMS), the Association of State and Territorial Health Officials and the National Association of Medicaid Directors, to help inform state Medicaid and public health agency implementation of 6|18 strategies — offering an unprecedented opportunity to help state agencies collaborate on enhancing the coverage, access, utilization, and quality of cost-effective prevention practices.

  • Phase I (2016-2017) supported nine states — Colorado, Georgia, Louisiana, Massachusetts, Michigan, Minnesota, New York, Rhode Island, and South Carolina — in adopting proven prevention strategies for Medicaid populations in three high-opportunity areas: asthma, tobacco, and unintended pregnancy prevention. The participating states worked to either enhance benefits related to the high-opportunity health conditions through payment or policy changes or increase the use of existing benefits.
  • Phase II (2017-2018) is working with Medicaid-public health teams, plus one local health department, from Alaska, Maryland, Nevada, North Carolina, Texas, Utah, Washington, DC, and Los Angeles County. Collectively, these participants are focusing on all of the 6|18 priority focus areas, with many addressing more than one health condition. Five states from Phase I — Colorado, Georgia, Louisiana, Rhode Island and South Carolina — are continuing their 6|18 efforts in 2017. CHCS is also engaging a group of commercial insurers in the 6|18 initiative this year.

Under the 6|18 initiative, CHCS, CDC, CMS, and other partners provide targeted technical assistance, peer-to-peer information exchange across state Medicaid and public health agencies, and in-person convening. They will also share case studies and resources from participating states to assist other payers and partners in implementing 6|18 strategies.

Over time, CDC expects to continue expanding the reach and impact of 6|18 interventions, with the goal of achieving significant, quantifiable cost savings and population health improvements in states all across the country.