American Institutes for Research to Support Federal Effort to Improve Outcomes for Medicare and Medicaid Recipients with Mental Health or Substance Use Conditions
CMS Innovation Center Contract Supports Implementation of Innovation in Behavioral Health Model
Arlington, Va. – The American Institutes for Research (AIR) has been awarded a contract to help improve the quality of care and physical and behavioral health outcomes for Medicare and Medicaid recipients who have moderate to severe mental health conditions or substance use disorders. Under the $73 million contract from the Center for Medicare and Medicaid Services (CMS) Innovation Center, AIR experts will support the implementation and monitoring of the Innovation in Behavioral Health (IBH) Model.
A quarter of all Medicare enrollees and 40 percent of all adult Medicaid enrollees experience mental illness or substance use disorders (SUD). These populations are more likely to experience unmet health care and health-related social needs, poor health outcomes, and premature death.
The IBH Model aims to integrate and coordinate care within specialty behavioral health practices to address Medicaid and Medicare patients’ behavioral and physical health, and health-related social needs, such as housing, food, and transportation. People served by this model can expect to receive more coordinated, whole-person care that may result in fewer visits to the emergency department, as well as improved quality of care and behavioral and physical health outcomes.
AIR will play a crucial role in implementing and monitoring this innovative Medicare-Medicaid payment model in eight states. Under this contract, AIR will:
- Support CMS and states in developing methodologies related to beneficiary attribution, quality measurement, performance scoring, and payment incentives;
- Provide technical assistance to states and behavioral health care practices for Model implementation;
- Collect data, score performance, and calculate Model payments; and
- Monitor health care quality, outcomes, and unintended consequences.
Rekha Varghese, a managing researcher at AIR, will serve as the project director. AIR’s partners in the project include General Dynamics Information Technology; Health Management Associates; iCare; and Clinical Consultant Elizabeth Salisbury-Afshar, MD.
“AIR is excited to work with the CMS Innovation Center to support solutions that will provide integrated, coordinated, and whole-person care and lead to better outcomes for Medicare and Medicaid enrollees,” said Timothy Hill, senior vice president for AIR’s Health Division. “This supports CMS’s goal to improve quality, equity, and outcomes for persons with mental health and substance use disorders as well as address their health-related social needs. It is also aligned with AIR’s mission to use evidence to create a better, more equitable world.”
The IBH contract is the latest in a series of new projects where AIR is supporting government agencies in bringing innovation and systemic improvements to the health care system:
- AIR is working with the CMS Innovation Center to help implement and monitor a new program that seeks to make transformative cell and gene therapy treatments more accessible to Medicaid recipients.
- Under a contract with the Health Resources and Services Administration (HRSA), AIR will support the efforts to strengthen the governance, transparency, and efficiency of the Organ Procurement and Transplantation Network.
Learn more about AIR’s research and technical assistance work in Health on the AIR website.
About AIR
Established in 1946, the American Institutes for Research (AIR) is a nonpartisan, not-for-profit organization that conducts behavioral and social science research and delivers technical assistance both domestically and internationally in the areas of education, health, and the workforce. AIR’s work is driven by its mission to generate and use rigorous evidence that contributes to a better, more equitable world. With headquarters in Arlington, Virginia, AIR has offices across the U.S. and abroad. For more information, visit www.air.org.