New CMS model to reward behavioral health integration with primary care

The Centers for Medicare & Medicaid Services (CMS) finalized the Innovation in behavioral health (IBH) model, and confirmed that state Medicaid agencies in Michigan, New York, Oklahoma, and South Carolina have been selected to participate.

IBH aims to improve care for Medicare and Medicaid beneficiaries living with mental health conditions and substance use disorders (SUD) by bridging the gap between mental and physical healthcare. The eight-year model begins on Jan. 1, 2025.

Model design

Central to IBH is the integration of behavioral health with physical health services, emphasizing a comprehensive and coordinated approach to patient care. This includes applying interprofessional care management strategies and strengthening health information technology (IT) systems capacity to improve care delivery and patient outcomes. Emphasis is placed on health equity, ensuring accessible and high-quality care for all beneficiaries, particularly those from underserved communities.

Selected locations

Oklahoma is implementing IBH statewide, while Michigan, New York, and South Carolina are implementing the model in designated sub-state geographic service areas. Additional details are forthcoming.

Practice participants

Per CMS, practice participants in IBH will be specialty behavioral health organizations and providers, including:

• Public or private practices
• Outpatient opioid treatment programs
• Community Mental Health Centers (CMHCs)
• Certified Community Behavioral Health Clinics (CCBHCs)
• Tribal health clinics
• Local health departments
• Hospital- or university-affiliated outpatient behavioral health programs or clinics
• Safety net providers where individuals can receive outpatient mental health and SUD services including Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs)