New Model to Focus on Improving Behavioral Health Outcomes

Jan. 18, 2024
CMS announces new model to test behavioral and physical health approaches

On Jan. 18, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare and Medicaid Services (CMS), announced the Innovation in Behavioral Health (IBH) Model to advance integration in behavioral health.

Per the news release from CMS, the model’s goal is to improve the overall quality of care and outcomes for adults with mental health conditions and substance use disorders (SUDs) by connecting them with the physical, behavioral, and social supports needed to manage their care. Additionally, the model will promote health information technology (health IT) capacity building through infrastructure payments and other activities, encouraging providers to transmit and exchange patient health information securely.

CMS will test the new IBH Model for addressing the behavioral and physical health, as well as health-related social needs of people with Medicaid and Medicare. Community-based health practices will create interprofessional care teams to provide person-centered care through integrated services. The care management teams are to address concerns that could negatively impact a person’s well-being, such as housing and food insecurity.

Participants in the IBH Model will be community-based behavioral health organizations and providers, including Community Mental Health Centers, public or private practices, opioid treatment programs, and safety net providers where people can receive outpatient mental health and SUD services. The model will incentivize these practice participants to work collaboratively to screen, assess, and coordinate between peoples’ physical and behavioral health needs.

Twenty-five percent of people with Medicare suffer from mental illness and 40 percent of adults with Medicaid experience mental illness or SUD. High costs and lack of access can make it challenging for people to receive the care they need.

“The systems of care to address physical and behavioral health conditions have historically been siloed, but there is a direct correlation between people with mental health conditions or substance use disorder and poor physical health,” said CMS deputy administrator and Innovation Center director Liz Fowler in a statement.

Soumi Saha, senior vice president, government affairs, at the Charlotte-based Premier Inc., said in a statement, “Premier is optimistic that the new model announced by the Centers for Medicare & Medicaid Services (CMS) can serve as an incubator to accelerate the research, testing and development of new interventions and other novel initiatives in critical areas where gaps exist for Medicaid and Medicare beneficiaries.” Saha goes on to say, “By supporting holistic, comprehensive, and multi-faceted approaches that encourage the use of advanced technology, data sharing and standardization, this model holds great potential to help solve healthcare’s most intractable challenges. Premier is deeply disappointed, however, that CMS is slow walking the implementation of the model. A crisis today needs answers today, not years from now.”

The IBH model, which will launch in Fall 2024, expands upon lessons learned from previous Innovation Center models that included community-based behavioral health practices. Interested states will need to apply for a Notice of Funding Opportunity.

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