Integrated Care for Kids (InCK) Model

The Integrated Care for Kids (InCK) Model is a child-centered local service delivery and state payment model that aims to reduce expenditures and improve the quality of care for children under 21 years of age covered by Medicaid through prevention, early identification, and treatment of behavioral and physical health needs. Some programs also include Children’s Health Insurance Program (CHIP) beneficiaries and pregnant woman over age 21 who are covered by Medicaid. The model empowers states and local providers to better address these needs, as well as the impact of opioid addiction through care integration across all types of healthcare providers.


  • The needs of children at greatest risk for physical and behavioral health issues, including children with mental health and substance abuse challenges, are often overlooked due to a disconnect between the health care system, schools, foster care, children welfare, and community resources and organizations. While many children enrolled in Medicaid and the Children's Health Insurance Program (CHIP) have behavioral health needs, very few receive support, and often the emergency department is the primary source of care.
  • The Integrated Care for Kids (InCK) Model works with state and local health service providers to identify at-risk children earlier, ensuring they receive appropriate treatment for their medical and behavioral health needs. Under the model, lead organizations, such as health providers, managed care organizations, and public health departments, oversee care coordination and case management among community partners, including schools and child welfare agencies.
  • By focusing on early intervention, children can get treatment sooner and often care is provided in home and community-based settings, rather than in the emergency department. Through this early identification and intervention approach, children can experience better health and wellbeing, both in the short term and over time.


Almost $126 million in InCK Model funding is being awarded to the states and organizations below for the 7-year Model launching in early 2020:

Select anywhere on the map below to view the interactive version
Source: Centers for Medicare & Medicaid Services



Chronic physical and behavioral health conditions in children and youth, including use of opiates and other substances, drive significant morbidity, health care utilization, and premature death. The current child health care system has challenges in identifying and addressing risk factors for complex physical and behavioral health conditions, because the earliest signs of a problem may present outside of clinical care—such as behavioral problems in schools, or chaotic family situations known to child welfare and foster care programs. Although a variety of federal, state, and local services exist to support children’s health, limited information sharing and differing eligibility and enrollment processes may create barriers to putting children and families at the center of their care.

Model Details

The goals of the InCK Model are to improve child health, reduce avoidable inpatient stays and out of home placement, and create sustainable Alternative Payment Models (APMs). The InCK Model  supports states and local providers to conduct early identification and treatment of children with health-related needs across settings. Participants are required to integrate care coordination and case management across physical and behavioral health and other local service providers to provide child-and family-centered care. Finally, through the APM that is developed under this model (launching in January, 2023), states and local providers will share accountability for cost and outcomes. These interventions are designed to increase behavioral health access, respond to the opioid epidemic and positively impact the health of the next generation.

The InCK Model aims to achieve these goals through:

Early identification and treatment of children with multiple physical, behavioral, or other health-related needs and risk factors through population-level engagement in assessment and risk stratification.

Integrated care coordination and case management across physical health, behavioral health, and other local service providers for children with health needs impacting their functioning in their schools, communities, and homes.

Development of state-specific APMs to align payment with care quality and supporting accountability for improved child health outcomes and long-term health system sustainability.


The key participants of the InCK Model are the state Medicaid agency, a local entity called a “Lead Organization,” and a Partnership Council. Additional details on participant roles are described below:

  • Lead Organizations convene community partners to integrate coordination and management of the InCK Model’s core child services for the attributed population. The Lead Organization is accountable for improving population-level care quality and outcomes and developing service integration protocols and processes. HIPAA-covered entities, including state Medicaid agencies, serve as Lead Organizations.


  • State Medicaid Agencies support local implementation by providing population-level data for the geographic service area, supporting the development of information sharing arrangements and infrastructure, working to align support for the model across child-focused state agencies, and developing the pediatric APM. State Medicaid agencies participate in the model regardless of whether they also serve as the Lead Organization.


  • Partnership Councils include representation from all core child services, community stakeholders and payers for the attributed population. These Partnership Councils, convened by the Lead Organization, are primarily responsible for devising strategies and processes to achieve the coordination of service types for the model.

The state Medicaid agency and Lead Organization partnered together to write the application, but only one of these entities was considered the applicant and the model awardee of a cooperative agreement.

If you are interested in receiving additional information about the Integrated Care for Kids (InCK) Model, please subscribe to the InCK Model listserv.

Evaluation Reports

Additional Information


Where Health Care Innovation is Happening