CMS awards funding to Maine to combat opioid misuse among expectant mothers

CMS announces Maine as participant in initiative to addresses opioid misuse among expectant and new mothers

Today, the Centers for Medicare & Medicaid Services (CMS) announced that it selected Maine as one of ten awardees for the Maternal Opioid Misuse (MOM) Model.

Maine also selected Maine General Medical Center, MaineHealth, MidCoast Parkview Hospital Behavioral Health Division, Eastern Maine Healthcare Systems (Northern Light Health), Penobscot Community Health Care, and Pines Health Services as their care-delivery partner(s) to implement the Model. The MOM Model is the next step in the Center for Medicare and Medicaid Innovation’s (Innovation Center) multi-pronged strategy to combat the nation’s opioid crisis. The Model addresses fragmentation in the care of pregnant and postpartum Medicaid beneficiaries with opioid use disorder (OUD) through state-driven transformation of the delivery system surrounding this vulnerable population. By supporting the coordination of clinical care and the integration of other services critical for health, wellbeing, and recovery, the MOM Model has the potential to improve quality of care and reduce costs for mothers and infants.

“The MOM model is a unique opportunity for healthcare providers in Maine to improve care for mothers and infants affected by the opioid crisis, and the model represents another step in President Trump’s agenda to combat the opioid crisis through holistic, compassionate treatment and recovery services” said HHS Secretary Alex Azar. “The model is aimed at promoting more coordination and integration of care, and we look forward to assessing the results of Maine as they work to support some of the most vulnerable mothers and their infants.”

The primary goals of the model are to:

• Improve quality of care and reduce expenditures for pregnant and postpartum women with OUD as well as their infants;
• Increase access to treatment, service-delivery capacity, and infrastructure based on state-specific needs; and
• Create sustainable coverage and payment strategies that support ongoing coordination and integration of care.

The MOM Model will have a five-year period of performance beginning in January 2020 with three different types of funding. Specifically, Implementation Funding, Transition Funding, and the opportunity for Milestone Funding will be provided in three distinct model periods: Pre-implementation (Year 1), Transition (Year 2), and Full Implementation (Years 3-5).

Care delivery will begin in Year 2, or the Transition Period, of the Model. During this year, funding for care-delivery services that are not otherwise covered by Medicaid will be provided by Innovation Center funds. By Year 3, the start of the Full Implementation Period, states must implement coverage and payment strategies. This overall structure seeks to balance rapid model initiation and state flexibility, while minimizing administrative burden. In particular, the MOM Model design supports each awardee’s ability to quickly begin delivering coordinated and integrated care to pregnant and postpartum women with OUD during the Transition Period, while supporting states in developing a long-term coverage and payment strategy that aligns with their state Medicaid program.

For additional information about the MOM Model, including a fact sheet and a list of participants, please visit: https://innovation.cms.gov/initiatives/maternal-opioid-misuse-model/