Funder: Centers for Medicare & Medicaid Services
Due Dates: September 8, 2025 (Estimated Application Due Date)
Funding Amounts: Up to $7.5 million per award over 7 years; up to 5 awards expected.
Summary: Funds state Medicaid agencies to test a 7-year value-based payment model for integrated behavioral healthcare for adults with mental health or substance use disorders.
Key Information: Only state Medicaid agencies (including DC and U.S. territories) are eligible; no cost sharing required.
Description
The Centers for Medicare & Medicaid Services (CMS) is launching a seven-year cooperative agreement to support state Medicaid agencies in implementing and evaluating a value-based payment (VBP) model for integrated behavioral health (BH) care. The Innovation in Behavioral Health (IBH) Model aims to align Medicaid and Medicare payment structures to promote integrated care delivery in specialty behavioral health organizations for adult beneficiaries with moderate to severe mental health conditions and/or substance use disorders (SUDs).
Up to five state Medicaid agencies (SMAs) will be selected to participate in this model, which includes a two-year pre-implementation period (2026–2027) and a five-year implementation period (2028–2032). The goal is to test the impact of VBP on care quality, access, and outcomes for adults with significant behavioral health needs.
Due Dates
- Estimated Application Due Date: September 8, 2025
- Estimated Project Start Date: January 1, 2026
Funding Amount
- Award Ceiling: $7,500,000 per recipient over seven years
- Expected Number of Awards: Up to 5
- Total Program Funding: $37,500,000
- Funding Instrument: Cooperative Agreement
- Cost Sharing/Matching: Not required
Eligibility
- Eligible Applicants: State Medicaid agencies (SMAs) with the authority and capacity to accept the cooperative agreement award.
- Geographic Scope: All 50 U.S. states, Washington DC, and U.S. territories (American Samoa, Guam, Northern Mariana Islands, Puerto Rico, U.S. Virgin Islands).
- Participation: Applicants may propose statewide or sub-state regional participation, subject to CMS approval.
- Note: Only SMAs are eligible; other organizations may participate as partners or sub-awardees but cannot apply directly.
Application Process
- This is a forecasted opportunity; the official Notice of Funding Opportunity (NOFO) is expected to be posted around June 18, 2025.
- Applications will be submitted via Grants.gov.
- Interested agencies should monitor the Grants.gov opportunity page for updates, application instructions, and required forms.
- Early engagement with CMS is encouraged for questions or clarifications.
Additional Information
- The IBH Model is voluntary and designed to promote integrated, value-based care in behavioral health settings.
- The model targets adult Medicaid, Medicare, and dually eligible beneficiaries with moderate to severe mental health and/or substance use disorders.
- The program includes a two-year pre-implementation phase for planning and a five-year implementation phase for model operation and evaluation.
- No cost sharing or matching is required.
- Applicants may propose to implement the model at the state or sub-state level, subject to CMS approval.
External Links
Contact Information