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The U.S. Department of Health and Human Services, via the Centres for Medicare and Medicaid Services (CMS), has introduced the Innovation in Behavioural Health (IBH) Model, leveraging digital technology to enhance care for Medicaid and Medicare beneficiaries. The model aims to address the holistic health needs of adults with mental health conditions and substance use disorders, fostering improved quality of care through interprofessional teams and health information technology (health IT) capacity building.
The Innovation in Behavioural Health (IBH) Model is an initiative launched by the CMS. This innovation aims to revolutionise the way mental health is treated. It aims to provide person-centred integrated care to Medicaid and Medicare populations with moderate to severe mental health conditions.
Under the CMS Innovation Centre, the IBH Model integrates community-based behavioural health practices into interprofessional care teams, consisting of behavioural and physical health providers alongside community-based supports. This model aligns with the President’s mental health strategy and implements a crucial action item in the HHS Roadmap for Behavioural Health (BH) Integration.
HHS Secretary Xavier Becerra emphasised the transformative impact of the IBH Model, aligning with the President’s Unity Agenda priority to combat the mental health crisis. The model, central to the Biden-Harris Administration’s commitment, envisions innovative solutions to support individuals with mental health conditions and substance use disorders by expanding access to high-quality care.
The IBH Model promotes a “no wrong door” approach, ensuring access to available services regardless of the entry point into care. This approach fosters integration between physical and behavioural health services, reducing gaps in care and overall programme expenditures. Deputy Secretary Andrea Palm underscored the administration’s dedication to a comprehensive approach, emphasising that anyone should access services regardless of their entry point.
CMS Administrator, Chiquita Brooks-LaSure, highlighted the model’s focus on integrated care, addressing behavioural and physical health as well as health-related social needs like housing, food, and transportation. With 25% of Medicare beneficiaries and 40% of adult Medicaid beneficiaries experiencing mental illness or substance use disorders, the IBH Model addresses gaps in care, especially for marginalised groups and those in rural areas.
Assistant Secretary for Mental Health and Substance Use, Dr Miriam E Delphin-Rittmon, emphasised the model’s potential to enhance behavioural health system infrastructure and staffing support. The IBH Model seeks to bridge historical silos in the healthcare system, recognising the direct correlation between mental health conditions, substance use disorders, and poor physical health.
Liz Fowler, CMS Deputy Administrator and Innovation Centre Director, underscored the model’s transformative nature, bringing together traditionally siloed healthcare components to provide comprehensive care. By integrating behavioural and physical health services, the model aims to prevent emergency department visits, enhance care management, and improve overall health outcomes.
Community-based behavioural health organisations and providers, including Mental Health Centres, private practices, opioid treatment programmes, and safety net providers, will participate in the IBH Model. Participants will receive incentives to address individuals’ physical and behavioural health needs collaboratively, supported by infrastructure payments for health IT capacity building, electronic health records, and practice transformation.
Building on lessons from previous Innovation Centre models, such as the Maternal Opioid Misuse Model and Integrated Care for Kids Model, the IBH Model demonstrates a commitment to value-based care for behavioural health. Anticipated to launch in Fall 2024 and operate for eight years in up to eight states, the model reflects CMS’s continuous efforts to enhance care through innovative approaches.
By integrating technology, fostering collaboration among diverse healthcare providers, and prioritising a person-centred approach, the IBH Model aims to create a more resilient and responsive behavioural health system for the benefit of Medicaid and Medicare beneficiaries across the United States. The upcoming years will provide valuable insights into the model’s effectiveness and its potential to reshape mental health care delivery nationwide.
