The Innovation in Behavioral Health Model: CMMI’s Latest Medicaid Innovation Frontier

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ATIWebinars
02/07/2024
AUTHOR – ATI Advisory

Summary

Brian Fuller, Managing Director of ATI Advisory’s Value-Based Care Design and Delivery Practice, and Johanna Barraza-Cannon, Director in ATI’s State Program & Policy Practice, reviewed and shared early observations on CMMI’s new model during the webinar, “The Innovation in Behavioral Health (IBH) Model: CMMI’s Latest in Medicaid Innovation Frontier.”  

Three New CMMI Models Offering Opportunities for States

CMS announced the new IBH Model a few weeks ago, signaling its focus on promoting the integration of behavioral health and physical health by creating a stream of care that will allow beneficiaries to navigate both physical and behavioral health needs with ease.  

In addition to IBH, CMMI has recently released two models targeted at states: States Advancing All-Payer Health Equity Approaches and Development (AHEAD) and Transforming Maternal Health (TMaH). AHEAD is an all-payer model blending clinical, non-clinical, and community-based supports. TMaH aims to reduce disparities in maternal healthcare access and treatment for Medicaid and CHIP enrollees, while reducing program expenditures. Both models target physical and behavioral health, as well as needs related to social determinants of health.  

All three models work with vulnerable and/or complex needs populations and offer opportunities for states to step in directly or convene network partners. 

What We Know about the IBH Model  

CMS will launch the IBH Model in up to eight state Medicaid agencies. Beneficiaries enrolled in Medicare and/or Medicaid with moderate to severe behavioral health conditions will be eligible for IBH. The pre-awardee implementation period will begin in Q4 2024, with implementation beginning in Q4 2027. More information will become available following the release of funding information by CMMI this spring. 

The IBH Model aims to help community-based behavioral health providers transition from Fee-For-Service (FFS) payment models to Value-Based Payment (VBP) models, ensuring high quality outcomes for beneficiaries.

Considerations for IBH Stakeholders 

Funding information for the IBH Model has yet to be announced; however, organizations can begin to consider the strategic implications of participating in IBH and other CMMI programs in the meantime. States will need to consider their competing financial and political priorities, as well as plan affiliations and other behavioral health innovation initiatives. Community providers will need to consider the potential operational challenges that would come with providing an integrated program of physical and behavioral health treatment. Health plans will need to plan for partnership with their state’s Medicaid agency if implementing the IBH model. 

Fuller and Barraza-Cannon closed the webinar with a discussion of value-based care trends and what ATI expects to see in the coming months.

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