CDC's 6|18 Initiative: Accelerating Evidence into Action

The Six Eighteen banner.

The reduce tobacco use evidence summary banner.

The control high blood pressure evidence summar banner.

The preventive healthcare-associated infections evidence summary.

The control asthma evidence summary banner.

The prevent unintended pregnancy evidence summary banner.

The control and prevent diabetes evidence summary banner.

In the 6|18 Initiative, CDC and partners are targeting six common and costly health conditions with 18 proven interventions.

CDC is collaborating with partners – like healthcare providers, public health workers, insurers, and employers who purchase insurance – to improve health and control healthcare costs by:

  • Giving partners rigorous evidence about high-burden health conditions and related interventions.
  • Highlighting disease-prevention interventions to increase their coverage, use, and quality.
  • Aligning proven preventive practices with value-based ways of paying for healthcare.

With this information, partners can make decisions that improve people’s health and help control costs.

New 6|18 Resources
6|18 Initiative: Key Actions

The 6|18 Initiative connects healthcare purchasers, payers, and providers with CDC researchers, economists, and policy analysts to find ways to improve health and control costs with the 6|18 interventions. In these new partnerships, CDC:

  • Provides peer-to-peer support, webinars, and quarterly calls with state Medicaid programs working with Public Health Departments to carry out 6|18 interventions.
  • Works with State Medicaid Agency-Public Health Department teams to understand and share best practices for applying 6|18 interventions.
  • Helps private insurance payers identify 6|18 interventions that will help their beneficiaries.
  • Collaborates with healthcare providers who are increasing their ability to deliver the 6|18 interventions that improve preventive services and patient care.
High-Burden Health Conditions and Evidence-Based Interventions

To improve health and control costs, CDC is prioritizing these six high-burden health conditions and effective interventions:

Prevent Unintended Pregnancy
Prevent Unintended Pregnancy
  • Reimburse providers for the full range of contraceptive services (e.g., screening for pregnancy intention; counseling; insertion, removal, replacement, or reinsertion of long-acting reversible contraceptives, and follow-up) for women of childbearing age.
  • Reimburse providers for the actual cost of FDA-approved contraceptive methods.
  • Unbundle payment for long-acting reversible contraceptives from other postpartum services.
  • Remove administrative barriers to receipt of contraceptive services (e.g., pre-approval step therapy restriction, barriers to high acquisition and stocking costs).
Control High Blood Pressure
control blood pressure
  • Implement strategies that improve adherence to anti-hypertensive and lipid-lowering prescription medications via expanded access to:
    • low cost medication copayments, fixed dose medication combinations, and extended medication fills;
    • innovative pharmacy packaging;
    • improved care coordination using standardized protocols, primary care teams, medication therapy management programs, and self-monitoring of blood pressure with clinical support.
  • Provide home blood pressure monitors to patients with high blood pressure and reimburse for the clinical support services required for self-measured blood pressure monitoring.
Reduce Tobacco Use
Reduce Tobacco Control
  • Increase access to tobacco cessation treatments, including individual, group, and telephone counseling, and Food and Drug Administration-approved cessation medications (in accordance with the 2008 Public Health Service Clinical Practice Guidelines and the 2015 U.S. Preventive Services Task Force recommendations).
  • Remove barriers that impede access to covered cessation treatments, such as cost-sharing and prior authorization.
  • Promote increased use of covered treatment benefits by tobacco users.
Control Asthma
control asthma
  • Use the 2007 National Asthma Education and Prevention Program as clinical practice guidelines.
  • Promote strategies that improve access and adherence to asthma medications and devices.
  • Expand access to intensive self-management education by licensed professionals or qualified lay health workers for patients whose asthma is not well-controlled with medical management.
  • Expand access to home visits by licensed professionals or qualified lay health workers to provide intensive self-management education and reduce home asthma triggers for patients whose asthma is not well-controlled with medical management and self-management education.
Improve Antibiotic Use
control healthcare-associated infections
  • Require antibiotic stewardship programs in all hospitals and skilled nursing facilities, in alignment with CDC’s Core Elements of Hospital Antibiotic Stewardship Programs and The Core Elements of Antibiotic Stewardship for Nursing Homes.
  • Improve outpatient antibiotic prescribing by incentivizing providers to follow CDC’s Core Elements of Outpatient Antibiotic Stewardship.
Prevent Type 2 Diabetes
Control and Prevent Diabetes
  • Expand access to the National Diabetes Prevention Program, a lifestyle change program for preventing type 2 diabetes.