Thursday, April 25, 2024
4/25/2024
The State of Indiana is poised to test innovative strategies to improve the quality of care and health outcomes for pregnant and postpartum women with opioid use disorder (OUD) and their infants while reducing Medicaid and CHIP expenditures. The Indiana Family and Social Services Administration (FSSA), which oversees the State’s Office of Medicaid Policy and Planning (OMPP) has designed the proposed Maternal Opioid Misuse Indiana Initiative (MOMII) program to address the growing opioid epidemic in Indiana and specific gaps in care. The number of overdose deaths specific to opioids has steadily increased in Indiana over the past two decades. Of the 61,425 pregnant women enrolled in Indiana Medicaid in 2018, 4.6% had a Medicaid claim for an OUD. OUD prevalence among pregnant women has compounded Indiana’s high infant mortality rate, which is one of the 10 worst in the country. Among mothers on Medicaid in Indiana, 992 infants were born with NAS in 2018; of those, 45% were related to opioids. In partnership with Indiana’s four Medicaid managed care entities (MCEs), FSSA will improve the quality of care and health outcomes while reducing expenditures through the following strategies. Collectively, these strategies are expected to result in a cost savings between $680,000 and $1,360,000 per year related to maternal and infant expenditures. • Value-based purchasing to incentivize patient outcomes – By incentivizing outcomes, FSSA’s model will lower per member/month costs and reduce infant mortality. Specifically, an enhanced rate for complex care coordination will improve outreach, care coordination and integration of services that will result in increased prenatal care (physical, behavioral, and SUD) and improved postpartum care (infant mortality and ongoing OUD treatment). • Social determinants of health (SDOH) screening and referrals – By standardizing the screening process and facilitating a shared platform for care coordination, FSSA will ensure that SDOH are identified and addressed in a timely and appropriate fashion. • Provider education and training – In collaboration with the Indiana University School of Medicine, FSSA will provide remote-based provider education and a learning collaborative for OUD treatment in pregnancy and NAS management. • Extend Medicaid coverage postpartum – By losing their coverage, women with OUD are at great risk of relapse with its accompanying complications. FSSA will extend coverage for this population to one year postpartum to address this gap. • Peer recovery coaches and family education – The value of peer recovery coaches in the treatment of persons with SUD is widely recognized. In addition, individual and family education around both OUD treatment as well as the pre and postpartum care and care of an infant is essential in assuring the best outcomes of mother and child. The MOMII strategy will include peer recovery coaching and connection to community-based home visiting services for individual and family education.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).
