Financing by Patient Population

Patient populations differ significantly in their health needs, benefit eligibility, and available coverage options, all of which affect the feasibility and design of financing strategies for integrated behavioral health (IBH). This section outlines the unique financial considerations and strategies for implementing and maintaining IBH for patients with substance use disorders (SUDs), dual-eligible beneficiaries, pediatric patients, and older adults.

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Patients with Substance Use Disorders (SUD)

Effective management of SUD in primary care settings often begins with standardized screening and brief interventions (e.g., cognitive behavioral therapy or motivational interviewing), followed by referral pathways to specialty treatment (e.g., intensive outpatient programs, residential treatment, or opioid treatment programs) or the initiation of pharmacological or medication-assisted treatment (e.g., buprenorphine or methadone).¹ SUD frequently co-occurs with physical and mental health conditions and is often compounded by housing instability and high use of emergency and acute care.^2,3 Primary care settings rely on a combination of Medicaid fee-for-service payment, federal and state grants, and legal settlement fund distributions to sustain IBH services for patients with SUD.⁴

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Key Considerations for Financing Integrated Behavioral Health for Patients with SUD

Key considerations for financing IBH functions for patients with SUD include:

Payment Provision: Some or all of the medications for alcohol use disorder, opioid use disorder, and tobacco cessation are covered by Medicare, Medicaid, and commercial insurers.^4–6 Methadone, a medication for opioid use disorder (MOUD), is only reimbursable by Medicare and Medicaid when dispensed at a certified opioid treatment program, and there may be prior authorization, visit limits, or dose caps for it and other MOUD, particularly with private payers.^7,8 Private payers are likely to exclude methadone from coverage.⁹ Naloxone, the medication that can rapidly reverse the effects of an opioid overdose, is covered by Medicare and Medicaid.^6,10 Learn more about Medicare coverage of substance use screenings and treatment (PDF – 4 MB), and Medicare coverage of mental health screening and treatments (PDF – 7 MB). See if your state Medicaid agency covers the medications for alcohol use disorder and opioid use disorder (PDF – 3 MB). See if your state Medicaid agency also covers tobacco cessation treatments.
Legal Settlement Funds: More than $50 billion in funding from lawsuits with pharmaceutical companies and distributors is being distributed to states and local governments (for up to 18 years), with the stipulation that most funds be used for opioid remediation activities, including treatment with MOUD in primary care and community-based settings.¹¹ There are also legal settlement funds from lawsuits with major tobacco and e-cigarette companies, though those funds tend to be dedicated to broader public health initiatives.^12–14 Legal settlement funds are distributed to primary care settings or providers via grants or contracts. Learn more about your state’s opioid settlement spending decisions.
Telehealth and Telemedicine: All primary care and behavioral health providers with a standard Drug Enforcement Administration (DEA) registration can prescribe buprenorphine via telehealth.¹⁵ Qualified staff within Opioid Treatment Programs (OTPs) have permanent authority under 42 CFR Part 8 to initiate (tele-prescribe) buprenorphine remotely without an initial in-person visit.¹⁶ Conversely, providers in office-based primary care settings currently rely on a temporary DEA extension to initiate buprenorphine remotely, which remains active through December 31, 2026.¹⁷ Medicare has permanently authorized the patient's home as an originating site and the use of audio-only technology for substance use treatment. The statutory requirement for an initial and annual in-person visit for these services has been waived through December 31, 2027.¹⁸ Medicaid and commercial coverage of substance use treatment via telehealth varies by state and plan.^19,20 Learn more about billing payers for substance use disorder treatment delivered via telehealth and about billing payers for mental health services delivered via telehealth.

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Strategies for Financing Integrated Behavioral Health for Patients with SUD

The table below provides strategies to address unique, patient population-specific financing considerations of patients with SUD. For additional strategies that are relevant, but not specific to patients with SUD, you can check:

Strategies for Financing Integrated Behavioral Health by Payer
Strategies for Financing Integrated Behavioral Health by Primary Care Setting

#

Strategy

Resources

1

Braid Multiple Funding Sources to Supplement Fee-For-Service (FFS)/Prospective Payment System (PPS) Payments

Combine core billing revenue (e.g., Medicaid FFS or PPS visits for federally qualified health centers) with additional sources such as state grants funded by the Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) State and Tribal Opioid Response Grant program or the Substance Use Prevention, Treatment, and Recovery Services Block Grant program, or opioid settlement funds and partnerships with community partners (e.g., hospitals, behavioral health providers, public health departments, jails, prisons, and drug courts) to cover non-billable services like wraparound supports.

AHRQ Academy: IBH Financing Toolkit: Potential Funding Sources

Centers for Medicare & Medicaid Services Medicare Learning Network: Substance Use Screenings & Treatment (PDF – 4 MB)

Centers for Medicare & Medicaid Services Medicare Learning Network: Medicare & Mental Health Coverage (PDF – 7 MB)

Substance Abuse and Mental Health Services Administration: State and Tribal Opioid Response Grants

Substance Abuse and Mental Health Services Administration: Substance Use Prevention, Treatment, and Recovery Services Block Grant (SUBG)

The National Academy for State Health Policy: Federal and State Funding Sources for Substance Use Disorder Treatment

Kaiser Family Foundation: Medicaid Waiver Tracker: Approved and Pending Section 1115 Waivers by State

The National Academy for State Health Policy: State Opioid Settlement Spending Decisions

2

Pursue SUD Specialty Provider Designation or Partner with Specialty Providers

Partner with or launch a Federally Qualified Health Center (FQHC) to receive PPS reimbursement and grant support for SUD services, an Opioid Treatment Program (OTP) for methadone reimbursement and access to bundled payments, or a Certified Community Behavioral Health Clinic (CCBHC) for enhanced Medicaid reimbursement and access to SAMHSA expansion grants.

Substance Abuse and Mental Health Services Administration: Section 223 Medicaid CCBHC Demonstration and State Programs

Substance Abuse and Mental Health Services Administration: Become an Opioid Treatment Program (OTP)

National Council for Mental Wellbeing: CCBHC Designated Collaborating Organizations (DCOs): FAQs

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Dual Eligible Patients (Medicare & Medicaid)

Patients who are dual eligible for Medicare and Medicaid often have complex health and social needs, including higher rates of chronic illness, functional limitations, and behavioral health conditions.²¹ For these patients, Medicare is the primary payer for physician, inpatient, and skilled post-acute care, while Medicaid supplements by covering premiums, cost sharing, and services not included in Medicare (e.g., long-term services, home- and community-based supports). This division creates financing gaps for IBH, causing these patients to face fragmented care.^22,23 Although Medicare is the first payer, this patient population typically relies on Medicaid for behavioral health services. Primary care settings often rely on a combination of Medicaid fee-for-service or managed care payment and participation in integrated plan models (e.g., Dual Eligible Special Needs Plans [D-SNPs]) to sustain IBH services for their dual eligible patients.²⁴

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Key Considerations for Financing Integrated Behavioral Health for Dual Eligible Patients

Key considerations for financing IBH for dually eligible patients include:

Coverage Requirements: The Bipartisan Budget Act of 2018 permanently authorizes Dual Eligible Special Needs Plans (D-SNPs), Medicare Advantage plans designed to integrate Medicaid and Medicare benefits for dually eligible beneficiaries.²⁵ D-SNPs bridge these gaps by integrating Medicare and Medicaid benefits and can be coordination-only, highly integrated, or fully integrated.²² Although states are not required to offer D-SNPs, all D-SNPs must have a contract with a state Medicaid agency to operate. D-SNPs can contract directly with primary care clinicians and settings to create their networks. States can require D-SNPs to provide or arrange for behavioral health services, including behavioral health integration codes, collaborative care models, and other social supports. Primary care clinicians or settings either submit a single claim to the D-SNP or separate claims to Medicare and Medicaid for the services provided. Learn more about coverage and billing requirements for beneficiaries who are eligible for both Medicare and Medicaid (PDF – 2 MB). Learn more about Medicare Advantage dual eligible special needs plans.

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Strategies for Financing Integrated Behavioral Health for Dual Eligible Patients

The table below provides strategies to address unique, patient population-specific financing considerations for dually eligible patients. For additional strategies that are relevant but not specific to dually eligible patients, you can check:

Strategies for Financing Integrated Behavioral Health by Payer
Strategies for Financing Integrated Behavioral Health by Primary Care Setting

#

Strategy

Resources

1

Partner with Dual Eligible Special Needs Plans (D-SNPs)

Engage in contracts with plans that integrate Medicare and Medicaid financing to simplify payment and expand coverage for IBH, care management, and social supports.

Centers for Medicare & Medicaid Services Medicare Learning Network: Beneficiaries Dually Eligible for Medicare & Medicaid (PDF – 2 MB)

Medicaid and CHIP Payment and Access Commission: Medicare Advantage Dual Eligible Special Needs Plans

2

Become a Medicaid Health Home or Join an Accountable Care Organization (ACO)

Leverage state Medicaid Health Homes or ACO contracts that align incentives across Medicare and Medicaid to fund care coordination, behavioral health integration, and population health supports.

Center for Health Care Strategies, Inc.: Using Health Homes to Integrate Care for Dually Eligible Individuals: Washington State’s Experiences (PDF – 303 KB)

Center for Health Care Strategies, Inc.: State Approaches to Integrating Physical and Behavioral Health Services for Medicare-Medicaid Beneficiaries: Early Insights (PDF – 332 KB)

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Pediatric Patients

Pediatric patients include children and adolescents from birth through age 18 (and, in some cases, up to age 21). They represent a unique population with developmental, family, and school-based contexts that shape behavioral health needs.²⁶ Most pediatric patients are covered through a parent or guardian’s employer-sponsored health plan—either a fully insured commercial plan or an employer self-insured plan administered by a commercial payer—or through Medicaid or the Children’s Health Insurance Program (CHIP). A smaller share is covered by individually purchased commercial insurance plans through the Affordable Care Act Health Exchange Marketplaces.²⁷ Medicaid requires coverage of behavioral health services, including developmental and behavioral health screenings, psychotherapy, group therapy, and other behavioral health services, under the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) mandate.²⁸ Primary care settings typically rely on fee-for-service payments or managed care arrangements,²⁹ though some states use school-based billing carve-ins, value-based payment models, or pediatric health homes to finance IBH.

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Key Considerations for Financing Integrated Behavioral Health for Pediatric Patients

Key considerations for financing IBH for pediatric patients include:

School-Based Health Clinics: Many children access IBH through school. Medicaid and commercial payers often restrict reimbursement to clinical settings, but some states have school-based health center policies and billing arrangements (via Medicaid carve-ins or state plan amendments) that can fund IBH services delivered in schools.^30,31 Learn more about school-based health centers and behavioral health care for students enrolled in Medicaid.

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Strategies for Financing Integrated Behavioral Health for Pediatric Patients

The table below provides strategies to address unique, patient population-specific financing considerations for pediatric patients. For additional strategies that are relevant but not specific to pediatric patients, you can check:

Strategies for Financing Integrated Behavioral Health by Payer
Strategies for Financing Integrated Behavioral Health by Primary Care Setting

#

Strategy

Resources

1

Partner with or Sponsor a School-Based Health Center (SBHC)

Leverage school-based health centers or district partnerships to co-fund behavioral health staff, with billing through Medicaid state plan amendments or carve-ins.

Centers for Medicare & Medicaid Services: Delivering Service in School-based Settings: A Comprehensive Guide to Medicaid Services and Administrative Claiming (PDF – 795 KB)

2

Become or Join a Pediatric Health Home, Patient-Centered Medical Home (PCMH), or Accountable Care Organization (ACO) to Leverage Value-Based Contracts

Join or become a pediatric PCMH, health home, or Medicaid ACO arrangement to align incentives around preventive behavioral health, care coordination, and social supports.

American Academy of Pediatrics: Medical Home Resources for Practices

American Academy of Pediatrics: Guiding Principles for Managed Care Arrangements for the Health of Newborns, Infants, Children, Adolescents and Young Adults

North Carolina Medical Society: Accountable Care Guide for Pediatric Care (PDF – 4 MB)

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Older Adult Patients

Many older adults—defined as individuals age 65 and older—are enrolled in Medicare, while a significant share is also dually eligible for Medicaid due to low income or functional limitations.³² This group often experiences multiple chronic conditions, cognitive decline (e.g., dementia, Alzheimer’s disease), and higher rates of depression, anxiety, and social isolation.^33,34 Traditional Medicare and Medicare Advantage plans are the primary payers, and for dually eligible patients, Medicaid provides critical wraparound supports such as long-term services.³⁵ Payment models for integrating behavioral health for older adult populations are shifting from traditional fee-for-service toward value-based arrangements and integrated financing models, such as the Program of All-Inclusive Care for the Elderly (PACE), which helps align medical, behavioral, and social supports.³⁶

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Key Considerations for Financing Integrated Behavioral Health for Older Adults

Key considerations for financing IBH for older adult patients include:

Coverage Requirements: The Balanced Budget Act of 1997 established the Program of All-Inclusive Care for the Elderly (PACE), a fully integrated financing model that combines Medicare and Medicaid funds to cover comprehensive medical, behavioral, and social services for frail elders. By pooling these funding streams, PACE enables flexible reimbursement for care coordination, team-based care, and supports that address social determinants of health, which are especially critical for older adults with complex needs.³⁷ PACE is a permanently available model under Medicare, but is an optional, voluntary program for both states and beneficiaries. States decide whether to create and run their own PACE programs. Most PACE participants qualify for both Medicare and Medicaid and receive all services without premiums, cost-sharing, or deductibles because their benefits are integrated. However, some Medicare beneficiaries who are not yet Medicaid-eligible must spend down their income or assets to meet their state’s Medicaid eligibility threshold before qualifying for PACE as a dual enrollee. Individuals enrolled only in Medicare or only in Medicaid may also participate, but they must pay higher monthly premiums to cover the portion of care not funded by their current program. Learn more about PACE.

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Strategies for Financing Integrated Behavioral Health for Older Adults

The table below provides strategies to address unique, patient population-specific financing considerations for older adult patients. For additional strategies that are relevant but not specific to older adult patients, you can check:

Strategies for Financing Integrated Behavioral Health by Payer
Strategies for Financing Integrated Behavioral Health by Primary Care Setting

#

Strategy

Resources

1

Participate in Program of All-Inclusive Care for the Elderly (PACE) Programs

Join PACE programs that pool Medicare and Medicaid capitated payments to finance integrated primary care, behavioral health, and long-term services.

National Association of Community Health Centers: Reimbursement Tips: Program of All-Inclusive Care for the Elderly (PDF – 2 MB)

National PACE Association: PACE: Frequently Asked Questions (PDF – 172 KB)

National PACE Association: High-Level PACE® Financial Proforma

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NIAC Note: Remember Why We Integrate

While we discuss cost, revenue, and savings in this toolkit, remember that behavioral health integration shouldn't be done because it’s financially stable—it should be done because it’s better medicine. It is the highest standard of patient care within a primary care setting and is a necessary service that improves practice and system outcomes, even if the individual department doesn't turn a profit.

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Resources

AHRQ Academy: IBH Financing Toolkit: Potential Funding Sources
American Academy of Pediatrics: Guiding Principles for Managed Care Arrangements for the Health of Newborns, Infants, Children, Adolescents and Young Adults
American Academy of Pediatrics: Medical Home Resources for Practices
Center for Health Care Strategies: State Approaches to Integrating Physical and Behavioral Health Services for Medicare-Medicaid Beneficiaries: Early Insights (PDF – 332 KB)
Center for Health Care Strategies: Using Health Homes to Integrate Care for Dually Eligible Individuals: Washington State’s Experiences (PDF – 303 KB)
Centers for Medicare & Medicaid Services: Delivering Service in School-based Settings: A Comprehensive Guide to Medicaid Services and Administrative Claiming
CMS Medicare Learning Network: Beneficiaries Dually Eligible for Medicare & Medicaid (PDF – 2 MB)
CMS Medicare Learning Network: Medicare & Mental Health Coverage (PDF – 7 MB)
CMS Medicare Learning Network: Substance Use Screenings & Treatment (PDF – 4 MB)
Kaiser Family Foundation: Medicaid Waiver Tracker: Approved and Pending Section 1115 Waivers by State
Medicaid and CHIP Payment and Access: Medicare Advantage Dual Eligible Special Needs Plans
National Association of Community Health Centers: Reimbursement Tips: Program of All-Inclusive Care for the Elderly (PDF – 2 MB)
National Council for Mental Wellbeing: CCBHC Designated Collaborating Organizations (DCOs): FAQs
National PACE Association: High-Level PACE® Financial Proforma
National PACE Association: PACE: Frequently Asked Questions (PDF – 172 KB)
North Carolina Medical Society: Accountable Care Guide for Pediatric Care (PDF – 4 MB)
SAMHSA: Become an Opioid Treatment Program (OTP)
The National Academy for State Health Policy: Federal and State Funding Sources for Substance Use Disorder Treatment
The National Academy for State Health Policy: State Opioid Settlement Spending Decisions

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1. Shapiro B, Coffa D, McCance-Katz EF. A Primary Care Approach to Substance Misuse. Am Fam Physician. 2013;88(2):113-121.

2. Common Comorbidities with Substance Use Disorders Research Report. National Institutes on Drug Abuse (US); 2020. Accessed September 29, 2025. http://www.ncbi.nlm.nih.gov/books/NBK571451/

3. Doran KM, Rahai N, McCormack RP, et al. Substance use and homelessness among emergency department patients. Drug Alcohol Depend. 2018;188:328-333. doi:10.1016/j.drugalcdep.2018.04.021

4. NASHP. Federal and State Funding Sources for Substance Use Disorder Treatment. February 19, 2025. Accessed September 29, 2025. https://nashp.org/funding-options-for-states/

5. STATE System Medicaid Coverage of Tobacco Cessation Treatments Fact Sheet. September 24, 2024. Accessed September 29, 2025. https://www.cdc.gov/statesystem/factheets/medicaid/cessation.html

6. Medicaid Coverage of Medications to Reverse Opioid Overdose and Treat Alcohol and Opioid Use Disorders | SAMHSA Library. Accessed September 29, 2025. https://library.samhsa.gov/product/medicaid-coverage-medications-reverse-opioid-overdose-treat-alcohol-opioid-use-disorders/pep22-06-01-009

7. Opioid Treatment Programs (OTP) | CMS. Accessed September 29, 2025. https://www.cms.gov/medicare/payment/opioid-treatment-program

8. Medicaid | CMS. Accessed September 29, 2025. https://www.cms.gov/medicare/payment/opioid-treatment-program/medicaid

9. McGinty EE, White SA, Eisenberg MD, Palmer NR, Brown CH, Saloner BK. US payment policy for medications to treat opioid use disorder: landscape and opportunities. Health Aff (Millwood). 2024;43(3):422-432. doi:10.1377/hlthaff.2024.00242

10. Opioid Use Disorder Treatment Coverage. Accessed November 3, 2025. https://www.medicare.gov/coverage/opioid-use-disorder-treatment-services

11. National Opioid Litigation: Settlement Agreements as of January 2025. Accessed November 3, 2025. https://www.congress.gov/crs-product/LSB11270

12. The Master Settlement Agreement and Attorneys General. National Association of Attorneys General. Accessed November 3, 2025. https://www.naag.org/our-work/naag-center-for-tobacco-and-public-health/the-master-settlement-agreement/

13. Public Health Law Center. Juul Litigation & Settlements: Frequently Asked Questions. 2023. Accessed November 3, 2025. https://www.publichealthlawcenter.org/sites/default/files/resources/Juul-Litigation-FAQ.pdf

14. How States Can Leverage JUUL Settlement Funds to Promote Public Health. Accessed November 3, 2025. https://www.astho.org/communications/blog/how-states-can-leverage-juul-settlement-funds-to-promote-public-health/

15. Expansion of Buprenorphine Treatment via Telemedicine Encounter. Federal Register. January 17, 2025. Accessed February 18, 2026. https://www.federalregister.gov/documents/2025/01/17/2025-01049/expansion-of-buprenorphine-treatment-via-telemedicine

16. 42 CFR Part 8 Final Rule. January 31, 2024. Accessed February 18, 2026. https://www.samhsa.gov/substance-use/treatment/opioid-treatment-program/42-cfr-part-8

17. DEA Extends Telemedicine Flexibilities to Ensure Continued Access to Care. Accessed February 18, 2026. https://www.dea.gov/press-releases/2025/12/31/dea-extends-telemedicine-flexibilities-ensure-continued-access-care

18. Telehealth policy updates | Telehealth.HHS.gov. Accessed September 21, 2025. https://telehealth.hhs.gov/providers/telehealth-policy/telehealth-policy-updates

19. Billing for substance use disorder (SUD) via telehealth. Accessed September 29, 2025. https://telehealth.hhs.gov/providers/best-practice-guides/telehealth-substance-use-disorder/billing-telehealth-substance-use

20. Billing for telebehavioral health | Telehealth.HHS.gov. Accessed September 29, 2025. https://telehealth.hhs.gov/providers/best-practice-guides/telehealth-behavioral-health/billing-for-telebehavioral-health

21. Pena M, Mohamed M, Burns A, Biniek J, Ochieng N, Chidambaram P. A Profile of Medicare-Medicaid Enrollees (Dual Eligibles). KFF. January 31, 2023. Accessed September 29, 2025. https://www.kff.org/medicare/a-profile-of-medicare-medicaid-enrollees-dual-eligibles/

22. Pena M, Mohamed M, Biniek J, Burns A, Cubanski J, Neuman T. The Landscape of Medicare and Medicaid Coverage Arrangements for Dual-Eligible Individuals Across States. KFF. October 24, 2024. Accessed September 29, 2025. https://www.kff.org/medicare/the-landscape-of-medicare-and-medicaid-coverage-arrangements-for-dual-eligible-individuals-across-states/

23. Improving Medicare–Medicaid Integration: Priorities of Dual-Eligible Adults Under Age 65. February 26, 2025. doi:10.26099/jjvp-y813

24. Improving Behavioral Healthcare for Dual Eligible Individuals: Opportunities and Challenges. Accessed September 29, 2025. https://atiadvisory.com/resources/wp-content/uploads/2024/11/Improving-Behavioral-Health-for-Dual-Eligible-Individuals.pdf

25. Medicare Advantage dual eligible special needs plans. MACPAC. September 8, 2023. Accessed September 29, 2025. https://www.macpac.gov/subtopic/medicare-advantage-dual-eligible-special-needs-plans-aligned-with-medicaid-managed-long-term-services-and-supports/

26. CDC. Data and Statistics on Children’s Mental Health. June 10, 2025. Accessed September 29, 2025. https://www.cdc.gov/childrensmentalhealth/data-research/index.html

27. Health Insurance Coverage of Children 0-18 | KFF State Health Facts. Accessed September 29, 2025. https://www.kff.org/state-health-policy-data/state-indicator/children-0-18/

28. Early and Periodic Screening, Diagnostic, and Treatment | Medicaid. Accessed September 29, 2025. https://www.medicaid.gov/medicaid/benefits/early-and-periodic-screening-diagnostic-and-treatment

29. An Introduction to Managed Care in CHIP. Center for Children and Families. March 24, 2023. Accessed September 29, 2025. https://ccf.georgetown.edu/2023/03/24/an-introduction-to-managed-care-in-chip/

30. School-based Health Centers and Behavioral Health Care for Students Enrolled in Medicaid. MACPAC. Accessed September 29, 2025. https://www.macpac.gov/wp-content/uploads/2025/03/School-based-Health-Centers-and-Behavioral-Health-Care-for-Students-Enrolled-in-Medicaid-Final.pdf

31. Medicaid Policies that Work for SBHCs. School-Based Health Alliance. Accessed September 29, 2025. https://www.sbh4all.org/federal-policy-and-advocacy/medicaid-policies-that-work-for-sbhcs/

32. Seniors & Medicare and Medicaid Enrollees | Medicaid. Accessed September 29, 2025. https://www.medicaid.gov/medicaid/eligibility/seniors-medicare-and-medicaid-enrollees

33. CDC FastStats: Older American Health. July 23, 2025. Accessed September 29, 2025. https://www.cdc.gov/nchs/fastats/older-american-health.htm

34. Behavioral Health Diagnosis, Service Utilization, and Spending Among Older Adult Medicare Beneficiaries: A Chartbook. 2025. Accessed September 29, 2025. https://aspe.hhs.gov/sites/default/files/documents/d94eafae1ef14dd58d7fa1cd728c932/older-adult-behavioral-health-chartbook.pdf

35. Seniors & Medicare and Medicaid Enrollees | Medicaid. Accessed September 29, 2025. https://www.medicaid.gov/medicaid/eligibility/seniors-medicare-and-medicaid-enrollees

36. Guenther J. How value-based care can transform health care for older adults. Permanente Medicine. June 20, 2025. Accessed September 29, 2025. https://permanente.org/how-value-based-care-can-transform-health-care-for-older-adults/

37. Program of All-Inclusive Care for the Elderly (PACE) | CMS. Accessed September 29, 2025. https://www.cms.gov/medicare/medicaid-coordination/about/pace

Financing by Patient Population

Patients with Substance Use Disorders (SUD)

Dual Eligible Patients (Medicare & Medicaid)

Pediatric Patients

Older Adult Patients

NIAC Note: Remember Why We Integrate

Resources

References