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Summary
On January 18, 2024, the Center for Medicare and Medicaid Innovation (CMMI) at the Centers for Medicare and Medicaid Services (CMS) announced Innovations in Behavioral Health (IBH), a new eight-year model focused on adult Medicaid and Medicare enrollees with moderate to severe mental health conditions and substance use disorders (SUD). CMS released substantial additional information about the model during a February 29 webinar and intends to release a notice of funding opportunity (NOFO) in Spring 2024.1 IBH will provide funding for states to work with behavioral health practices to develop and implement new care delivery models, with a focus on care management, that aim to integrate physical and behavioral health. The IBH care delivery model must be accompanied by a value-based payment (VBP) methodology. Consistent with CMMI’s “Strategy Refresh,” IBH adds to CMMI’s growing portfolio of Medicaid and Children’s Health Insurance Program (CHIP)-focused models – including the States Advancing All-Payer Health Equity Approaches and Development (AHEAD) model, Transforming Maternal Health (TMaH) Model, and the Cell and Gene Therapy Access model.
State Medicaid agencies will administer the IBH model in partnership with state agencies that oversee mental health and SUD services and Medicaid managed care plans where relevant. Up to eight states will be eligible to receive up to $7.5 million in cooperative agreement funding over the course of the model’s eight-year implementation timeline, which is slated to begin in the fourth quarter of 2024. Cooperative agreement funding will be used to build capacity at both state Medicaid agencies and behavioral health practices. Participating behavioral health practices will have the option of participating in IBH for only their Medicaid populations or for both their Medicaid and Medicare populations. CMS aims for IBH to produce the following outcomes:
- Enhanced quality and delivery of whole person care
- Increased access to behavioral health, physical health, and health-related social needs (HRSN) services
- Improved health and equity outcomes
- Fewer avoidable emergency department and inpatient visits
- Strengthened health information technology systems capacity