Participating providers will receive federal support for integrating mental and physical healthcare services in team-based care
The Centers for Medicare & Medicaid Services is launching a new model to test the integration of mental health and primary care services, giving healthcare organization an opportunity to leverage new strategies and technologies in a team-based care approach.
The Innovation in Behavioral Health (IBH) Model will be tested through the CMS Innovation Center (CMI), which will align Medicare and Medicaid reimbursements through state-based programs. The idea is to create a care management plan for patients living with mental health issues and/or substance use disorder that incorporates mental and physical healthcare.
“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,” CMS Deputy Administrator and Innovation Center Director Liz Fowler said in a press release issued Friday. “This model will bring historically siloed parts of the health system together to provide whole-person care--designed to keep people out of the emergency department, ensuring better care management and coordination, and improving their overall health.”
The eight-year program will launch this fall in as many as eight states. CMS is expected to release a Notice of Funding Opportunity sometime this spring.
The model lends federal support and funding to a concept being tested by healthcare organizations across the country. Faced with an onslaught of patients living with behavioral health issues and a shortage of resources, providers are turning to team-based care to give these patients a more comprehensive care plan. The team-based approach also supports the theory that many behavioral and substance abuse issues stem from or are exacerbated by other health concerns, including chronic conditions.
The model also enables providers to fold in services and resources that address barriers to care, or social determinants of health (SDOH), to affect many underserved patients, especially those in Medicare and Medicaid programs.
“Addressing the nation’s behavioral health crisis remains a key priority for CMS,” CMS Administrator Chiquita Brooks-LaSure said in the press release. “Through this model, CMS will support behavioral health practices to provide integrated care and help meet people’s behavioral and physical health and health-related social needs, like housing, food, and transportation, all of which can negatively impact a person’s ability to manage their care.”
CMS officials say the model will incentivize participating providers “to work collaboratively to screen, assess, and coordinate between individuals’ physical and behavioral health needs.” The model also gives providers a chance to use virtual and digital health technologies to improve access to treatment and support services.
The IBH Model also builds off of earlier CMI programs that sought to advance value-based care, including the Maternal Opioid Misuse Model, Integrated Care for Kids Model, and Value in Opioid Use Disorder Treatment Demonstration.
Eric Wicklund is the associate content manager and senior editor for Innovation, Technology, and Pharma for HealthLeaders.
KEY TAKEAWAYS
Mental health issues affect one of every four Medicare patients and roughly 40% of those on Medicaid, yet access to care providers is limited.
Health systems across the country are experimenting with integrating behavioral and physical care services to improve care management and clinical outcomes
CMS is launching a new payment model through the CMS Innovation Center aimed at developing new, integrated care management platforms that address both physical and mental health concerns