General Implementation Tools

Following are practical tools to help Medicaid agencies, state and local health departments, and other payers and purchasers plan, design, implement, and assess CDC’s 6|18 Initiative prevention activities.

These general tools are complemented by a collection of priority condition specific tools and will be updated regularly as lessons from state and local agencies implementing 6|18 interventions emerge.

Explore Resources by Stakeholder Group

The following resources can help Medicaid and public health officals, as well as managed care organization staff, to implement high-opportunity prevention interventions.

Explore Resources by Topic

The following resources can help stakeholders implement high-opportunity prevention interventions.

These general tools are complemented by a collection of priority condition specific tools.

Getting Started Guide to CDC's 6|18 Initiative

View the guide »

Making the Business Case for CDC's 6|18 Interventions

Conducting a Program Cost Analysis for Medicaid-Public Health 6|18 Prevention Programs – Brief designed to help Medicaid and public health partners perform a cost analysis and build a financial case for 6|18 interventions. (CHCS, June 2018)
Making the Business Case for CDC’s 6|18 Initiative Interventions: Key Considerations – This tip sheet provides guidance for Medicaid-public health teams interested in presenting a business case to state or health plan leadership related to Medicaid coverage for an evidence-based intervention under the 6|18 Initiative. (CHCS, August 2019)
Making the Business Case for 6|18 Interventions – Webinar addresses how to build the business case for new or expanded Medicaid prevention policies. (Center for Health Care Strategies, January 2019)
What’s Your ROI? A Web-Based Tool to Estimate Economic Returns on Investments for Public Health Agency Projects – Website provides background information and links to a tool and tutorial for calculating the ROI of public health agency programs. (Association of State and Territorial Health Officials)
Estimating Return on Investment for Public Health Improvements: Tutorial on Using the New Tool – Presentation on estimating the return on investment on public health improvement programs using a tool developed by the University of Kentucky. (Association of State and Territorial Health Officials, June 2013)
ROI Toolkit: A Guide for Conducting a Return on Investment Analysis of Your Community Health Worker Program – Toolkit describes how to calculate ROI for community health worker programs. (MHP Salud, 2016)
Rhode Island’s Home Asthma Response Program – Fact sheet outlines the business case for implementing Rhode Island’s the Home Asthma Response Program. (State of Rhode Island, 2016)
Return on Investment for Tobacco Cessation – Guide created for Minnesota Medicaid outlines the return on investment for tobacco cessation programs for providers/health systems, insurers/employers, and state Medicaid agencies. (Clearway Minnesota, April 2016)

Delivering Prevention-Oriented Care through Partnerships

Understanding Medicaid’s Role in CDC’s 6|18 Initiative: Primer and FAQ – This primer and FAQ document describe the core roles of Medicaid staff when partnering with their public health counterparts to implement evidence-based prevention interventions under CDC’s 6|18 Initiative. (CHCS, June 2019)
Understanding Public Health’s Role in CDC’s 6|18 Initiative: Primer and FAQ – This primer and FAQ document describe the core roles of state/territorial public health agencies when partnering with their Medicaid counterparts to implement evidence-based prevention interventions under CDC’s 6|18 Initiative. (CHCS, June 2019)
Partnering to Catalyze Comprehensive Community Wellness: An Actionable Framework for Health Care and Public Health Collaboration – This report provides a framework to help facilitate collaborative working relationships between the public health and health care sectors. It outlines essential elements of collaboration and presents key strategies for effective partnerships. (Public Health Leadership Forum, June 2018)
Catalyst for Collaboration – Infographic shares themes from state Medicaid and public health officials’ partnerships in CDC’s 6|18 Initiative. (CDC, 2017)
Resources on Maximizing Public Health Partnerships with Medicaid to Improve Health – Website includes materials, case studies, and a learning series to help promote collaborative opportunities between Medicaid and public health agencies designed to achieve the Triple Aim of better care, reducing costs and improving population health outcomes. (Association of State And Territorial Health Officials)
Using Collaborative Practice Agreements to Support Medicaid Prevention Interventions: Models and Resources to Engage Pharmacists – Technical assistance brief provides background information on Collaborative Practice Agreements (CPAs), CPA laws, state protocols, and related resources for 6|18 teams seeking to engage pharmacists to help increase access and reduce barriers to evidence-based interventions. (Association of State and Territorial Health Officials, June 2018)
Advancing Team-Based Care Through Collaborative Practice Agreements: A Resource and Implementation Guide for Adding Pharmacists to the Care Team – Guide for pharmacists to use in developing and executing collaborative practice agreements in the spirit of advancing team-based care. (CDC, 2017)
Community Health Worker Certification and Financing – Brief provides an overview of options for community health worker (CHW) certification and financing and offers recommendations for state health agencies looking to collaborate with stakeholders to promote health system transformation and health workforce innovation involving CHWs. (Association of State and Territorial Health Officials, 2017)
Community Health Worker Successes and Opportunities for States – Brief provides an overview of how public health departments can utilize CHWs to improve community health outcomes and generate cost-savings. (Association of State and Territorial Health Officials, 2017)
Technical Assistance Guide: States Implementing Community Health Worker Strategies – Guide supports states to use community health worker (CHW) strategies to prevent and control heart disease and other chronic conditions, with a specific focus on integrating CHWs into health care teams. (CDC, December 2014)
Managing Community Health Worker Contracts – Article describes contract design considerations for organizations developing a CHW workforce. (Public Health Post, August 2017)
Telehealth Resource Guide – Guide for state and territorial health officials includes background information on telehealth and its different modalities, an overview of telehealth legislation and regulation at the federal and state levels, and considerations for developing a telehealth pilot. (Association of State and Territorial Health Officials, September 2017)

Payment and Reimbursement Strategies for Prevention Activities

Implementing Prevention Strategies to Support State Medicaid Value-Based Payment Reforms – Brief can help Medicaid and public health officials make the case for investing in prevention strategies and aligning these efforts to help achieve state value-based payment goals. (Center for Health Care Strategies, June 2018)
Medicaid Reimbursement for Community-Based Prevention – Report summarizes opportunities for promoting prevention though delivery reform in Medicaid and includes a questionnaire to prepare organizations to engage state Medicaid officials about pursuing a State Plan Amendment. (Trust for America’s Health and Nemours, 2013)
Medicaid Premiums and Cost Sharing – Brief summarizes literature on the impact of Medicaid premiums and cost sharing upon enrollment, service utilization and health status. (National Health Law Program, May 2014)
Roadmap of Medicaid Prevention Pathways – Resource describes how state Medicaid agencies and their partners can maximize existing authorities under federal Medicaid and CHIP laws to deliver a range of preventive services and strategies at both the individual and population levels. (Nemours, March 2017)
Implementing a State-Level Quality Improvement Collaborative: A Resource Guide from the Medicaid Network for Evidence-Based Treatment – Guide for state agencies, policymakers, and stakeholders seeking to implement state-level quality improvement collaboratives to address a specific clinical concern affecting the Medicaid population. (Agency for Healthcare Research and Quality, October 2014)

Engaging Managed Care Organizations

Engaging Medicaid Managed Care Organizations in 6|18 – Webinar explores strategies for successful state engagement with Medicaid managed care organizations to promote coverage and adoption of evidence-based prevention strategies. (Center for Health Care Strategies, November 2016)
Performance Improvement Projects Related to CDC’s 6|18 Initiative: A Scan of External Quality Review Organization Reports – Report provides a scan of External Quality Review Organization (EQRO) technical reports that included performance improvement projects related to: controlling asthma, preventing diabetes, controlling high blood pressure, and reducing tobacco use. It can help states more strategically partner with Medicaid MCOs on prevention-related activities by learning from other states’ efforts. (SHADAC, June 2018)
Managed Care Organization Survey Questions to Assess Asthma Control Services – Sample questions compiled from surveys used by Medicaid and public health programs across the country to assess how asthma control services and medications are being covered, promoted, reimbursed, tracked and evaluated by managed care organizations. (Center for Health Care Strategies, June 2018)
Managed Care Organization Survey Questions to Assess Smoking Prevalence and Available Cessation Benefits – Sample questions compiled from surveys used by Medicaid and public health programs across the country to gather information about tobacco cessation benefits from managed care organizations. (Center for Health Care Strategies/CDC, June 2018)

Measuring Implementation Progress

Monitoring Progress and Outcomes in CDC’s 6|18 Initiative – Technical assistance brief describes qualitative and quantitative measures and key steps/processes/activities that states can use to assess CDC’s 6|18 Initiative prevention activities. (Center for Health Care Strategies/ State Health Access Data Assistance Center, June 2018)
Measuring the Impact of CDC’s 6|18 Initiative – Webinar describes how state Medicaid and public health agencies can evaluate the impact of 6|18 Initiative prevention interventions. (Center for Health Care Strategies, September 2017)
Framework for Program Evaluation in Public Health – Tool summarizes key elements of program evaluation for public health agencies seeking to plan effective public health strategies, improve existing programs, and/or demonstrate program results. (CDC, 2017)
Statistical Brief on the Health Care Access Module, 2013 and 2014 – Brief provides guidance to researchers seeking to conduct analyses of Behavioral Risk Factor Surveillance System data, which addresses health care access, affordability and use. (CDC, October 2015)