A new voluntary payment model aims to improve whole-person care for children enrolled in Medicaid and the Children's Health Insurance Program (CHIP) who have complex medical and behavioral needs.

The Center for Medicare & Medicaid Innovation (CMMI) announced the Accelerating State Pediatric Innovation Readiness and Effectiveness (ASPIRE) Model on March 24. Under this model, state Medicaid agencies will be accountable for the quality and cost of care for beneficiaries up to age 21 who have or are at risk of developing complex medical or behavioral conditions. About half of children and youth in this population are covered by Medicaid or CHIP, and many face fragmented and difficult-to-navigate care systems that can worsen outcomes and lead to greater long-term health needs, according to the Centers for Medicare & Medicaid Services (CMS).

The ASPIRE Model aims to coordinate care across physical and behavioral health services for children with behavioral health conditions; substance use disorders; chronic conditions; and certain physical, intellectual, and developmental disabilities. CMS plans to release a Notice of Funding Opportunity in 2026 and will select up to five states to participate in the 10-year model.

Contact Director of Policy Rob Nelb, MPH, at [email protected] or 202.585.0127 with questions.