By OPEN MINDS Circle
On December 18, 2024, the Centers for Medicare & Medicaid Services (CMS) announced that state Medicaid agencies in Michigan, New York, Oklahoma, and South Carolina were selected to participate in the Innovation in Behavioral Health (IBH) Model. This model will test approaches for addressing the behavioral and physical health, as well as health-related social needs, of people with Medicaid and Medicare. Model implementation will begin on January 1, 2025. The IBH Model is anticipated to operate for eight years in these states.
The IBH Model’s goal is to improve the overall quality of care and outcomes for adults with mental health conditions and/or addiction by connecting them with the physical, behavioral, and social supports needed to manage their care. Under IBH, community-based behavioral health practices will form interprofessional care teams consisting of behavioral and physical health providers, as well as community-based supports. The model will also promote health information technology (health IT) capacity building through infrastructure payments and other activities. Features of the model include:
- An integration of services that will bridge the gaps between physical and behavioral health.
- A “no wrong door” approach, which welcomes participants and offers them all services, no matter how they enter care.
Practice participants in the IBH Model will be community-based behavioral health organizations and providers, including Community Mental Health Centers, public or private practices, opioid treatment programs, and safety net provider organizations where individuals can receive outpatient mental health and addiction services. The model will incentivize these practice participants to work collaboratively to screen, assess, and coordinate between individuals’ physical and behavioral health needs. Practice participants will be equipped with the necessary resources to facilitate integrated care, including infrastructure payments to support health IT capacity building, electronic health records, and practice transformation; technical assistance; and a predictable value-based payment model.
Intended outcomes of the IBH Model include:
- Enhanced quality and delivery of whole-person care
- Increased access to behavioral health, physical health, and health-related social needs services
- Improved health and equity outcomes
- Fewer avoidable emergency department and inpatient visits
- Strengthened health IT systems capacity
Approximately 25% of people with Medicare experience mental illness and 40% of adult people with Medicaid experience mental illness or addiction.
For more information, contact: Office of Communications, U.S. Centers for Medicare & Medicaid Services, 7500 Security Boulevard, Baltimore, Maryland 21244; 202-690-6145; Website: https://www.cms.gov