Comparing the InCK & MOM Models

Focus Population

All attributed Medicaid beneficiaries from prenatal stage up to age 21. Awardees may also include CHIP beneficiaries. Awardees may also include pregnant Medicaid beneficiaries over the age of 21.

Pregnant and postpartum Medicaid beneficiaries with opioid use disorder (OUD) and their infants.

Model Goals

The 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 under 21 years of age covered by Medicaid and CHIP through prevention, early identification, and treatment of behavioral and physical health needs. The model intends to improve performance on priority measures of child health, reduce avoidable inpatient stays and out-of-home placements, and create sustainable APMs.

The MOM Model aims to address fragmentation in the care of pregnant and postpartum Medicaid beneficiaries with opioid use disorder (OUD) through state-driven transformation of the delivery system surrounding this vulnerable population. By supporting the coordination of clinical care and the integration of other services critical for health, wellbeing, and recovery, the MOM model has the potential to improve quality of care and reduce costs for mothers and infants.

Model Intervention

• Population stratification approach that assesses risk for every eligible beneficiary with a comprehensive needs assessment tool.
• Requires integrated care coordination and case management of clinical care with seven other cross-sector core child health services.

• Coordinated and integrated care-delivery approach, including addressing beneficiaries’ physical and behavioral health needs.
• Requires screening, treatment, and referral to critical wraparound services, with the flexibility to define the specific set of services that satisfy five components:  

1. Comprehensive care management;
2. Care coordination;
3. Health promotion;
4. Individual and family support; and,
5. Referral to family and social services.

Payment Model

State-designed Alternative Payment Models (APMs).

State-designed coverage and payment strategy.

Model Timeline

Seven-year model, with implementation beginning in Year 3.

Five-year model, with care delivery under the model beginning in Year 2.

Awardee Types

State Medicaid Agency or HIPAA-covered local Lead Organization.

State Medicaid agency that has partnered with at least one care-delivery partner.

Required Model Partners

• State Medicaid Agency
• Local Lead Organization
• Core Child service providers: Physical and mental health providers, child welfare, schools, early care and education, food and nutrition, housing, Title V programs, and mobile crisis services.

• Care-delivery partner(s), such as: Health system or Managed Care Plan.

Model Service Area

Single or multiple sub-state geographic service area(s); cannot be statewide

Statewide or in a sub-state geographic service area

Number of Awardees

8

10

States with Awards

Connecticut, Illinois (2 awards), New Jersey, New York, North Carolina, Ohio and Oregon

Colorado, Indiana, Louisiana, Maine, Maryland, Missouri, New Hampshire, Tennessee, Texas, and West Virginia

Total Year 1 Funds Awarded

$23,297,741

$7,432,809 of Implementation Funding

Anticipated Award Start Date

January 1, 2020