CMS Releases NOFO Application for IBH Model  

An educational webinar on the process is being hosted next month.

Federal health officials have announced the release of the Notice of Funding Opportunity (NOFO) application period for the newly introduced Innovation in Behavioral Health (IBH) Model.   

Applications are being accepted through Sept. 9, with $60 million in total program funding available and an individual award ceiling of $7.5 million. More information is available online here: https://www.grants.gov/search-results-detail/354873

Centers for Medicare & Medicaid Services (CMS) officials noted that the IBH Model, unveiled in January, is “focused on improving the behavioral and physical health outcomes and quality of care for people with Medicaid and Medicare who experience moderate to severe behavioral health conditions.” The model seeks to bridge the gap between behavioral and physical health by enabling specialty behavioral health practices to integrate behavioral health with physical healthcare and health-related social needs.

Up to eight states will be selected as initial participants. These state Medicaid agencies (SMAs) will lead the way in the early stages of the Model, with a goal of aligning payment between Medicaid and Medicare for integrated care. First steps will include developing necessary infrastructure and capacity, along with the recruitment of “Practice Participants” to deliver care, and the SMAs will receive funding to support necessary upgrades to health information technology, electronic health records, practice transformation activities, and staffing to implement the model.

Award notices will be issued to selected SMAs in mid-December.

Additional supplementary information, including an IBH Model Overview Fact Sheet and a Fact Sheet for Model Benefits for SMAs, are available at this dedicated subsection of the CMS website: https://www.cms.gov/priorities/innovation/innovation-models/innovation-behavioral-health-ibh-model

CMS officials also noted that they are holding an informational webinar on the topic on July 11, with upcoming model announcements, events, and resources available. Any questions, they said, can be directed to the IBH Model team at IBHModel@cms.hhs.gov.

The news comes on the heels of the recent addition of 10 states to the Certified Community Behavioral Health Clinic (CCBHC) Medicaid Demonstration Program. A joint project by the U.S. Department of Health and Human Services (HHS), CMS, and the Substance Abuse and Mental Health Services Administration (SAMHSA), it will now involve services in Alabama, Illinois, Indiana, Iowa, Kansas, Maine, New Hampshire, New Mexico, Rhode Island, and Vermont, after each successfully developed necessary state-level infrastructure and worked with providers to develop programs that meet CCBHC standards.

A CMS press release issued earlier this month notes that the pilot “provides states with sustainable funding that helps them expand access to mental health and substance use services,” supporting a broader effort to overhaul the nation’s behavioral health system – an effort that also includes the transition to the national 988 Suicide & Crisis Lifeline, as well as the additions of a new mobile crisis benefit to Medicaid and new crisis codes to the Medicare program.

CMS has noted that a quarter of all people enrolled in Medicare experience mental illness, and 40 percent of all adults enrolled in Medicaid experience mental illness or substance use disorders (SUDs); enrollees in both programs reportedly experience disproportionately high rates of each, and as a result are more likely to experience poor health outcomes and experiences, like frequent visits to the emergency department, hospitalizations, or premature death.