Seven States Begin Work on Integrated Care for Kids Payment Model

Feb. 4, 2020
Participants will work to integrate care coordination, case management across physical and behavioral health and other local service providers

Almost $126 million in federal funding is being awarded to seven states and lead organizations for a seven-year Integrated Care for Kids (InCK) model launching this year.

The InCK model is described as a child-centered local service delivery and state payment model that aims to reduce expenditures and improve the quality of care for children under 21 years of age covered by Medicaid through prevention, early identification, and treatment of behavioral and physical health needs.

Some programs also include Children’s Health Insurance Program (CHIP) beneficiaries and pregnant woman over age 21 who are covered by Medicaid. The alternative payment model is designed to empower states and local providers to better address these needs, as well as the impact of opioid addiction through care integration across all types of healthcare providers.

The participating states are Connecticut, Illinois, North Carolina, New Jersey, New York, Ohio and Oregon.

The goals of the InCK Model are to improve child health, reduce avoidable inpatient stays and out-of-home placement, and create sustainable alternative payment models (APMs). The InCK Model will support states and local providers to conduct early identification and treatment of children with health-related needs across settings. Participants will be required to integrate care coordination and case management across physical and behavioral health and other local service providers to provide child-and family-centered care. Finally, through the APM that is developed under this model, states and local providers will share accountability for cost and outcomes. These interventions are designed to increase behavioral health access, respond to the opioid epidemic and positively impact the health of the next generation.

The InCk Model aims to achieve these goals through:

• Early identification and treatment of children with multiple physical, behavioral, or other health-related needs and risk factors through population-level engagement in assessment and risk stratification.

• Integrated care coordination and case management across physical health, behavioral health, and other local service providers for children with health needs impacting their functioning in their schools, communities, and homes.

• Development of state-specific APMs to align payment with care quality and supporting accountability for improved child health outcomes and long-term health system sustainability.

As an example, in Oregon, the Oregon Health Authority (OHA) has been awarded up to $16 million over seven years from CMS to improve health for children and youth covered by Medicaid and CHIP in in Marion, Polk, Crook, Deschutes and Jefferson counties.

OHA will partner with the Oregon Pediatric Improvement Partnership (OPIP) at Oregon Health & Science University and local communities to better integrate services across behavioral health, physical health, and other family supports to meet the triple aim of better health, better care and lower costs. "This is an exciting opportunity to bring extra resources to this region, connecting community partners, healthcare providers and families to wrap resources around our kids," said Dana Hargunani, M.D., OHA's chief medical officer, in a statement. "We will be able to take what we learn from this work to help improve children’s health across the state."

The funding includes up to $3 million for the first two years for planning and partnership development and up to $2 million for each of the five implementation years, with some funding contingent on performance