CMS Announces New State Opportunity to Advance Behavioral Health Care Integration

Last week, the Centers for Medicare & Medicaid Services (CMS) announced a new state opportunity to test approaches for addressing behavioral, physical, and health-related social needs of individuals covered by Medicaid and Medicare.

Structured as a new “Innovation in Behavioral Health” (IBH) model to be tested by the CMS Innovation Center, the state-based model is focused on supporting individuals covered by Medicaid and Medicare with moderate to severe mental health conditions and substance use disorders. Under the model, state-selected participating community-based behavioral health practices (“practice participations”) will be responsible for conducting screenings and assessments of behavioral, physical and health-related social needs, offering treatment as appropriate within their scope of practice, providing “closed loop” referrals to other primary care providers, specialist, and community-based resources, monitoring ongoing conditions and creating a health equity plan. According to CMS, the goal of the model is to improve care through care integration, care management, health equity and health information technology.

CMS will select up to eight state Medicaid agencies to participate in the model through a Notice of Funding Opportunity expected to be released this spring. The IBH model is then projected to run for eight years including a pre-implementation period of one to three years, during which states and practice participants will receive funding to develop and implement model activities and for capacity building. By the fourth year of the model, states will be expected to implement a Medicaid payment model that supports practice participants in implementing the care delivery framework.

More details on the IBH model including eligibility criteria can be found here. As always, we will keep our Say Ahhh! readers posted as we learn more.

Anne Dwyer is an Associate Research Professor at the Georgetown University McCourt School of Public Policy’s Center for Children and Families.