CMS rolls out payment model for pregnant women with opioid use disorder

CMS on Oct. 23 introduced the Maternal Opioid Misuse model, which seeks to provide better care coordination for pregnant and postpartum Medicaid members with opioid use disorder.

Currently, many pregnant and postpartum women with opioid use disorder lack access to quality treatment. There is also a shortage of providers in rural areas hit hard by the epidemic. The MOM model aims to achieve the following three goals:

  • Improve care quality while reducing cost for pregnant and postpartum women with OUD and their infants.
  • Increase treatment access, service capacity and infrastructure based on states' specific needs.
  • Create sustainable patient coverage and payment strategies while supporting ongoing coordination efforts and integrative care.

As part of the program, the CMS Innovation Center will form up to 12 cooperative agreements with states where Medicaid agencies will implement the model with one or more "care delivery partners."

The MOM model will have a five-year performance period comprised of a one-year pre-implementation period, a one-year transition period and three years of full implementation. The model will also offer different types of funding, including implementation, transition and milestone funding. This structure aims to balance rapid model expansion and state flexibility without aggravating administrative duties.

"The MOM model will support state Medicaid agencies, front-line providers and healthcare systems to help ensure that mothers and infants afflicted by the opioid epidemic get the care they need," HHS Secretary Alex Azar, said in a press release.

More articles on opioids: 

Drug overdose deaths fell over last 6 months, CDC finds
EMRs are hospitals' tech-of-choice for opioid management, KLAS finds
White House rolls out 2nd opioid ad as part of public awareness campaign

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