Monthly Archives

July 2017

CMMI Focuses on Behavioral Health

Practice area:

The Shift to Value Based Reimbursement Needs to Address Behavioral Health Access and Costs

CMS recently announced that the Center for Medicare and Medicaid Innovation (CMMI) is interested in lowering the cost of care for Medicare and Medicaid beneficiaries with behavioral health conditions while improving the quality of care and the overall access to care for those patients, and will convene a public meeting in the fall to discuss ideas to accomplish these goals. Notably, CMMI indicated that such a model may include participation by other payers, qualify as an Advanced Alternative Payment Model, improve health care provider participation in telehealth services, and address the needs of beneficiaries with care deficiencies in certain areas that lead to poor clinical outcomes or potentially avoidable expenditures, such as substance use disorders, mental disorders with comorbidities, Alzheimer’s disease, and/or behavioral health workforce challenges.  As we deal with an aging population and continue to confront the reality that clinical interventions account for only a small part of managing