Health Center State Policy

InCK: CMMI’s Promising New Payment Model for Children

By Bethany Hamilton, JD (Deputy Director, State Affairs, NACHC) and Anoosha Hasan (NACHC State Affairs Intern, University of Maryland)

Photo Credit: Holly Trenerry, Shasta Community Health Center

The Center for Medicare and Medicaid Innovation (CMMI) rolled out a promising new initiative to address behavioral needs for children through an integrated state delivery and payment model. In a few months, the public will learn how funding will be awarded for up to eight cooperative agreements to implement the Integrated Care for Kids (InCK) Model with a project period of January 1, 2020 through December 31, 2026.

What is CMMI’s InCK Model? While sometimes framed as a model focused on addressing the opioid epidemic, the InCk Model addresses much more.  In August 2018, CMMI presented the InCK model as an opportunity to develop innovative alternative payment models (APM) focused on children. The integrated APM aims to reduce expenditures and improve the quality of care for children under 21 years covered by Medicaid and CHIP through prevention, early identification, and treatment of behavioral and physical health needs. In recognizing that a child’s health is influenced by early indicators present through school, community, and home life, the InCK model promotes an integrated care coordination approach involving case management across physical and behavioral health.

With a maximum of only eight awardees, the landscape of participants was strategically designed to include both public and private partners. The InCK model awardees will each consist of a state Medicaid agency and a local, HIPAA-covered lead organization working together to create the APM.  In a well-developed implementation timeline which respects varying state-level issues and needs, the APM is not expected to be created until year four of the award performance period. 

Photo Credit: Colleen Curtis, United Health Centers

CMMI’s selection of InCK model award recipients will soon reveal which states and their partners were able to integrate this significant initiative into their ongoing state efforts; tell us more about the willingness of providers to participate without the threat of “downside risk”; and, given their experience in treating vulnerable populations, whether any health centers were included as a lead organization, or otherwise.

To learn more, see the InCk Marks website. FQHCs who may be participating in a selected model are strongly encouraged to reach out to state@nachc.org if they have questions or information to share.

This project was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under cooperative agreement number U30CS16089, Technical Assistance to Community and Migrant Health Centers and Homeless for $6,375,000.00. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.

The NACHC team thanks State Affairs intern Anoosha Hasan for her significant contributions to this blog post, and we wish her continued success in her academic and professional endeavors.