1/13/2024 0 Comments Cms triple aimHIPAA-covered entities, including state Medicaid agencies, will be eligible to serve as Lead Organizations. The Lead Organization will be accountable for improving population-level care quality and outcomes and developing service integration protocols and processes. Lead Organizations will convene community partners to integrate coordination and management of the InCK Model’s core child services for the attributed population. The key participants of the InCK Model will be the state Medicaid agency and a local entity called a “Lead Organization. State participants will work with CMS and Lead Organization to develop APMs responsive to local contexts and priorities that leverage the broad array of existing mandatory and optional Medicaid and CHIP benefits to empower providers and promote cost-savings, improved quality, and state flexibility. Model participants will build community capacity to provide more effective, efficient, and affordable care through home- and community-based services (HCBS), reducing unnecessary inpatient stays and out-of-home placements. InCK participants will deliver child- and family-centered integrated care and case management for children with physical, behavioral, and other health-related needs like food insecurity and unstable housing. The InCK Model aims to achieve these goals through: The InCK Model will award states and local communities cooperative agreements to build on existing delivery system innovations with the goals of: These interventions are designed to increase behavioral health access, respond to the opioid epidemic and positively impact the health of the next generation. Finally, through the APM that is developed through this model, states and local providers will share accountability for cost and outcomes. Participants will be required to integrate care coordination and case management across physical and behavioral health and other local service providers to provide child- and family-centered care. The InCK Model will support states and local providers to conduct early identification and treatment of children with health-related needs across settings. The goals of the InCK Model are to improve child health, reduce avoidable inpatient stays and out of home placement, and create sustainable alternative payment models (APMs). Although a variety of federal, state, and local services exist to support children’s health, limited information sharing and differing eligibility and enrollment processes may create barriers to putting children and families at the center of their care. The current child health care system has challenges in identifying and addressing risk factors for behavioral health conditions, because the earliest signs of a problem may present outside of clinical care-such as behavioral problems in schools, or chaotic family situations known to child welfare and foster care programs. Furthermore, adolescent deaths from drug overdose are increasing, and opioids caused over half of drug-related overdoses among youth in 2015. One in three children in Medicaid and CHIP have behavioral health needs, yet only one-third of those in need receive care. The model will offer states and local providers support to address these priorities through a framework of child-centered care integration across behavioral, physical, and other child providers.īehavioral health conditions in children and youth, including use of opiates and other substances, drive significant morbidity, health care utilization, and premature death. The Integrated Care for Kids (InCK) Model is a child-centered local service delivery and state payment model aimed at reducing expenditures and improving the quality of care for children covered by Medicaid and the Children’s Health Insurance Program (CHIP) through prevention, early identification, and treatment of priority health concerns like behavioral health challenges and physical health needs. The Center for Medicare and Medicaid Innovation (Innovation Center) has announced a new model, tested under the authority of section 1115A of the Social Security Act, as part of a multi-pronged strategy to combat the nation’s opioid crisis.
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