Advancing Implementation of CDC’s 6|18 Initiative

The Centers for Disease Control and Prevention’s (CDC) 6|18 Initiative 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.

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 align efforts to enhance the coverage, access, utilization, and quality of cost-effective prevention practices. The 6|18 interventions complement activities that CDC state public health grantees are pursuing for the six targeted conditions and provide an opportunity to advance that work through strategic partnerships. CHCS also partners with the following 6|18 Initiative technical assistance providers: Faulkner Consulting Group, the National Association of Chronic Disease Directors, and Leavitt Partners.

Now in its fourth year, this unique opportunity has supported 40 states, local jurisdictions, and territories across the United States in adopting proven prevention strategies by enhancing benefits related to high-opportunity health conditions. Participating Medicaid and public health teams benefit from targeted technical assistance, peer-to-peer information exchange, and an annual in-person convening.

• Year I (2016-2017) supported nine states, including Colorado, Georgia, Louisiana, Massachusetts, Michigan, Minnesota, New York, Rhode Island, and South Carolina.
• Year II (2017-2018) worked with six states — Alaska, Maryland, Nevada, North Carolina, Texas, Utah — as well as the District of Columbia and Los Angeles County’s local health department.
• Year III (2018-2019) worked with 17 states and one U.S. territory — 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) is assisting 16 states and three U.S. territories — 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.

To read more about state and territory interventions undertaken as part of the 6|18 Initiative — including spotlights on select state activities — visit the 6|18 in Action page.

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.