New CMS Model to Reward Behavioral Health Integration with Primary Care

The Centers for Medicare & Medicaid Services (CMS) announced the Innovation in Behavioral Health (IBH) Model, aiming to improve care for Medicare and Medicaid beneficiaries living with mental health conditions and substance use disorders (SUD).

The eight-year model focuses on integrated care and enhancing the coordination and effectiveness of treatment. Eight states will be selected to develop this model in collaboration with relevant agencies and Medicaid managed care organizations.

Model Design

Central to the IBH Model is the integration of behavioral health with physical health services, emphasizing a comprehensive approach to patient care. This includes applying innovative management strategies and the utilization of advanced health information technology to improve care delivery and patient outcomes. A strong emphasis is placed on health equity, ensuring accessible and high-quality care for all beneficiaries, particularly those from underserved communities.

Eligible Participants

Per CMS, 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
  • Safety net providers where individuals can receive outpatient mental health and SUD services

Timeline and Payments

In years one through three, the model will provide infrastructure payments to support investment in the staffing, IT, and workflow changes needed to implement the model.

In years four through eight, the model will provide payments for aligned beneficiaries for implementation of the care delivery framework, as well as quality incentive payments.

Next Steps

CMS plans to issue a Notice of Funding Opportunity in Spring 2024, with the launch of the model expected in Fall 2024. The Fact Sheet provides key information, including more details about the expected timeline.

We’re Here to Help

If you’re interested in applying to the IBH Model, please reach out to your Moss Adams professional. Our health care strategy team can provide more information about program requirements and support with operational and financial planning.

Additional Resources

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