CMS launches new model to integrate physical and mental health

Steven Loeb · January 22, 2024 · Short URL:

People with Medicare and Medicaid will be connected with physical, behavioral, and social support

Along with society allowing people to be more open about their mental health struggles in recent years, one of the other big changes is a move to a more holistic view of the body. That means that mental and physical health are no longer seen as separate from each other but rather as intertwined: curing physical health problems can help with mental health problems, and vice versa. You can't treat one without the other. 

Also, while mental health issues are a problem among all demographics, they are a particular issue for the Medicare and Medicaid population: 25% of people with Medicare experience mental illness, while 40% of adult people with Medicaid experiencing mental illness or substance use disorder (SUD).

That's why the U.S. Department of Health and Human Services, through the Centers for Medicare & Medicaid Services (CMS), announced a new model, called Innovation in Behavioral Health (IBH), in which it will test approaches for addressing the behavioral health, physical health, and social needs of this population.

The IBH Model will connect adults who have mental health conditions and/or SUD with community-based behavioral health organizations and providers, such as Community Mental Health Centers, public or private practices, opioid treatment programs, and safety net providers where individuals can receive outpatient mental health and SUD services. 

Practice participants will be incentivized to work together to screen, assess, and coordinate between individuals’ physical and behavioral health needs. In addition, they will receive 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. 

The model enables what CMS calls a “no wrong door” approach, which means that, regardless of how patients enter care, they will have access to all available services. 

IBH, which is expected to launch in Fall of this year, and is anticipated to operate for eight years in up to eight states, will be tested by the Center for Medicare and Medicaid Innovation (CMS Innovation Center).

“I am proud of all the work we have done to change the way mental health is treated in this country for the better. This new behavioral health model released today will help states to advance this goal, in line with the President’s Unity Agenda priority to tackle the mental health crisis,” HHS Secretary Xavier Becerra said in a statement.

“The Biden-Harris Administration will continue to explore innovative ways to help people with mental health conditions and/or substance use disorder. Put simply, mental health is health—and by expanding access to the high-quality care that people need, we are changing lives.”

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