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With the recent announcements of two new innovation models, the Centers for Medicare & Medicaid Services (CMS) is recognizing the role of digitally enabled care in improving access and outcomes.
The Transforming Maternal Health (TMaH) model will issue cooperative agreements to up to 15 state Medicaid agencies to participate in a ten-year payment and care delivery model to develop and implement a whole-person approach to pregnancy, childbirth, and postpartum care for individuals covered by Medicaid and the Children’s Health Insurance Program (CHIP). To support development and implementation, participating state Medicaid agencies will be eligible for up to $17 million in funding and technical assistance. CMS intends to release a Notice of Funding Opportunity (NOFO) in Spring 2024 with additional information ahead of the January 2025 model go-live date. Manatt analyzed the TMaH model’s key initiatives and outlined considerations for state Medicaid agencies in a recent Manatt Health Highlights newsletter.
The Innovation in Behavioral Health (IBH) model will select up to eight state Medicaid agencies to develop and implement state-administered approaches which integrate behavioral, physical, and social supports to coordinate and manage care for Medicare and Medicaid beneficiaries with moderate-to-severe mental health conditions or substance-use disorders (SUD). The model centers on four key pillars: care integration, care management, health equity, and health information technology. To support development and implementation, participating state Medicaid agencies will be eligible for up to $7.5 million in cooperative agreement funding. CMS intends to release a NOFO in Spring 2024 with additional information ahead of the Summer 2024 application deadline.