CMS Rolls Out Data-Informed Behavioral Health Strategy

April 15, 2022
CMS’ Innovation Center is testing models to improve behavioral healthcare and improve quality while reducing cost, including the Integrated Care for Kids Model

The Centers for Medicare & Medicaid Services has developed a Behavioral Health Strategy, which seeks to remove barriers to care and services, and to adopt a data-informed approach to evaluate behavioral health programs and policies.

At the CMS quality conference this week, Shari Ling, M.D., CMS deputy chief medical officer and medical officer in the Center for Clinical Standards and Quality (CCSQ), said “the COVID pandemic has challenged us to take a closer look at the needs of our beneficiaries, particularly around mental healthcare and services. CMS was able to provide several flexibilities during COVID-19 to include expanding Medicaid coverage and allowing for broader range of services to be delivered by way of telehealth.”

Ling also noted that while advancing equity and quality are foundational elements across all CMS initiatives, the Behavioral Health Strategy is no exception.

CMS plans to incorporate health equity into new care and payment models and optimize whole-person care for beneficiaries with and at risk of behavioral health conditions. It also will seek to provide outreach and education on its behavioral health services to inform beneficiaries, caregivers and providers utilizing culturally and linguistically appropriate materials that meet the needs of individuals with low literacy, low health literacy, and limited-English proficiency.

“We seek to strengthen equity and quality in behavioral health,” Ling said. “We also seek to improve access to substance use disorders prevention, treatment, and recovery services to ensure effective pain treatment and management, to improve mental healthcare services, and finally, to utilize data for effective actions and impact,” Ling said. “Each goal also has corresponding objectives that provide action steps that help us to measure progress toward the achievement of each goal.”

CMS’ Innovation Center is testing models to improve behavioral healthcare and improve quality while reducing cost, including the Integrated Care for Kids Model, which aims to meet physical and behavioral health needs in children, and the Value in Treatment Model, to increase access to OUD services and improve health outcomes in people with OUD.

Another goal is to improve the care experience for people with substance use disorders. CMS plans to strengthen treatment and recovery services through innovative care and payment models, and dissemination of promising and best practices. It will also seek to expand workforce capacity across provider types, including exploring options for training of residents and clinicians in the detection, diagnosis and management of substance use disorders.

Underpinning all its goals is using data for effective actions and impact on behavioral health. CMS plans to build on and support cross-departmental and interagency collaborations related to data such as the HHS Behavioral Health Coordinating Council actions. An example of this type of work is the Mapping Medicare Disparities Tool, which helps identify areas of disparities between subgroups of Medicare beneficiaries (e.g., racial and ethnic groups) in health outcomes, utilization, and spending.

“CMS will continue to look across programs and policies and initiatives that support our beneficiaries in support of these strategic goals,” Ling said, adding that quality improvement organizations (QIOs) have been leading and supporting behavioral health initiatives across the country. “We look forward to our continued work with the QIO program to align future projects with this new behavioral health strategy.”

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