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CMS’ Advancing Chronic Care with Effective, Scalable Solutions model launched July 5, testing whether paying organizations for outcomes — rather than specific services — can expand access to technology-supported chronic care.
Behavioral health is one of four clinical tracks, alongside musculoskeletal pain and two cardio-kidney-metabolic tracks split by disease stage, putting depression and anxiety management on equal footing with physical chronic conditions in a first-of-its-kind national payment test.
“The biggest shift we’re seeing [in behavioral health] is this movement toward whole health and truly integrated care models,” said Anh Kremer, chief strategy and development officer at Sagent Behavioral Health. “With this administration, we’re seeing at least some federal focus on coordination between physical health, behavioral health and social determinants of health.”
The model will run for 10 years through June 2036, with CMS accepting applications on a rolling basis through 2033. Participating organizations will receive recurring “outcome-aligned payments” for managing patients’ qualifying conditions, with full payment tied to hitting measurable health targets rather than logging specific billable activities.