CMS Announces Behavioral Health Innovation Center Model

By The Policy Center’s Policy Team

Our work shaping and reporting on national mental health policy is made possible through a 2020-2023 capacity grant from the Perigee Fund.

On January 18, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), announced a new model to test approaches for addressing behavioral and physical health in a bi-directional way: The Innovation in Behavioral Health (IBH) Model which will be piloted in 8 states.

The program’s goal is to improve the overall quality of care and outcomes for adults with mental health conditions and/or substance use disorder by connecting them with the physical, behavioral, and social supports needed to manage their care.  

The model will also promote health information technology (health IT) capacity building through infrastructure payments and other activities. 

Through the interprofessional care teams, people will experience an integration of services that will bridge the gaps between physical and behavioral health. The model enables a “no wrong door” approach, meaning that regardless of how patients enter care, they will have access to all available services – medical care in behavioral health care settings or vice-versa.

“We will continue to test approaches that close the gaps between how behavioral and physical health are treated. Our goal is always to improve the overall quality of care and outcomes for patients, and this model brings us one step closer,” said HHS Deputy Secretary Andrea Palm. 

The impact of behavioral health conditions is significant among the Medicare and Medicaid populations, with 25% of people with Medicare experiencing mental illness and 40% of adult people with Medicaid experiencing mental illness or substance use disorder (SUD).1 High out-of-pocket costs for care, lack of access to quality behavioral health treatment in some areas, and often fragmented systems of care can make it difficult for people to obtain the care they need. This is particularly true for historically marginalized racial and ethnic groups, low-income populations, and individuals living in rural areas.

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 providers where individuals can receive outpatient mental health and SUD 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. 

The IBH Model builds upon earlier efforts by the Center for Medicare and Medicaid Innovation (CMMI) to include community-based behavioral health practices, including both mental health providers and substance use disorder providers, in value-based care. The IBH Model is based on the lessons learned from previous Innovation Center models, such as the Maternal Opioid Misuse Model, Integrated Care for Kids Model, and the Value in Opioid Use Disorder Treatment Demonstration

The model will launch in Fall 2024 and is anticipated to operate for eight years in up to eight states. CMS will release a Notice of Funding Opportunity for state Medicaid Agencies in Spring 2024.

Visit the IBH Model webpage for more information

Frequently Asked Questions about the Innovation in Behavioral Health Model

View a fact sheet on the model

View a fact sheet of the accomplishments to date on the HHS Roadmap for Behavioral Health Integration