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Conceptual Framework and Strategic Considerations for Modernizing Behavioral Health Systems

NASHP

State Medicaid programs, behavioral health authorities, public health, departments of insurance, human and social service agencies, departments of education, departments of corrections, housing, and employment can collaborate to align overlapping efforts, align policies, and braid funding and accountability mechanisms.

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National Care Coordination Standards for Children and Youth with Special Health Care Needs (CYSHCN): Proceedings from the National Forum on Care Coordination for CYSHCN

NASHP

The “National Forum on Advancing High-Quality, Equitable Care Coordination for Children and Youth with Special Health Care Needs” centered on two key topics for improving care coordination systems for CYSHCN: integrated care coordination and the care coordination workforce.

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CMS Issues Contract Year 2023 Final Rule for Medicare Advantage Organizations and Prescription Drug Sponsors

Sheppard Health Law

Considering the impact social risk factors and unmet social needs can have on health, CMS asserts these changes will help better identify the risk factors that may inhibit enrollees from accessing care and achieving optimal health outcomes, enabling MA SNPs to take these risk factors into account in enrollee care plans. and 422.107).

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Behavioral Health System Modernization: Comprehensive Approaches and Cross-Cutting Tools

NASHP

As major purchasers, administrators, and regulators of behavioral health treatment and supports, states play a critical role in system transformation. In addition, through its new 1115 demonstration extension and “Roadmap for Behavioral Health Reform,” the state is phasing in a new integrated primary care payment and reimbursement structure.

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State Community Health Worker Models

NASHP

integrating?CHWs ACO Accountable Care Organizations. RAE Regional Accountable Entity. Rhode Island’s Medicaid Accountable Entities (similar to ACOs) may use funds earned through the Health System Transformation Project Incentive Fund to fund CHW services. Acronym Guide. APM Alternative Payment Model.

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Behavioral Health System Modernization along the Continuum

NASHP

It includes examples from various states organized by the framework buckets: integrated primary and behavioral health care, crisis continuum of care, in-home and in-community based, and out-of-home and community. States have a range of tools and policy levers at their disposal to build capacity for integrated behavioral health approaches.

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CMS’ Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs

Sheppard Health Law

Refining Definitions for Fully Integrated and Highly Integrated D-SNPs (§§ 422.2 In the preamble of the Proposed Rule, CMS states that it hopes to improve the integration of Medicare and Medicaid programs for individuals enrolled in D-SNPs. Additional Opportunities for Integration through State Medicaid Agency Contracts.