‘‘(L) how the hospital will collect and orga-
nize data and fully participate in the learning 
collaborative established under subsection (e). 
‘‘(3) PARTICIPATION; PAYMENTS.—The Sec-
retary shall negotiate an annualized payment ar-
rangement with each eligible hospital participating 
in the program. Such arrangement may include an 
annual lump sum amount, capitated payment 
amount, or such other arrangement as determined 
appropriate by the Secretary, and which may include 
an arrangement that includes financial risk for the 
hospital, to support implementation of the innova-
tions specified in the plan described in paragraph 
(2). 
‘‘(e) LEARNING COLLABORATIVE.— 
‘‘(1) IN GENERAL.—The Secretary shall estab-
lish a learning collaborative that shall convene eligi-
ble hospitals participating in the program and other 
interested parties on a regular basis to report on 
and share information regarding evidence-based in-
novations addressing mental and physical health 
comorbidities, innovations addressing social deter-
minants of health, and associated metrics and out-
comes. 
VerDate Sep 11 2014 
22:27 Apr 07, 2025
Jkt 059200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6201
E:\BILLS\H2590.IH
H2590
ssavage on LAPJG3WLY3PROD with BILLS
‘‘(2) FOCUSED FORUMS.—The Secretary may 
establish different focused forums within the collabo-
rative, such as ones that specifically address dif-
ferent geographic regions (such as urban and rural), 
certain types of comorbidities, or as the Secretary 
otherwise determines appropriate based on the types 
of agreements entered into under subsection (d). 
‘‘(3) DISSEMINATION
OF
INFORMATION.—The 
Secretary shall provide for the dissemination to 
other health care providers and interested parties of 
information on promising and effective activities. 
‘‘(f) DEFINITIONS.—For purposes of this section: 
‘‘(1) APPLICABLE INDIVIDUAL.—The term ‘ap-
plicable individual’ means an individual with mental 
and physical health comorbidities who is— 
‘‘(A) a subsidy eligible individual (as de-
fined in section 1860D–14(a)(3)(A)) without 
regard to clause (i) of such section; 
‘‘(B) enrolled under a State plan (or waiv-
er of such plan) under title XIX; or 
‘‘(C) uninsured. 
‘‘(2) ELIGIBLE HOSPITAL.—The term ‘eligible 
hospital’ means a hospital that is— 
‘‘(A) a rural hospital with a dispropor-
tionate patient percentage of at least 35 percent 
VerDate Sep 11 2014 
22:27 Apr 07, 2025
Jkt 059200
PO 00000
Frm 00008
Fmt 6652
Sfmt 6201
E:\BILLS\H2590.IH
H2590
ssavage on LAPJG3WLY3PROD with BILLS
(as determined by the Secretary under section 
1886(d)(5)(F)(vi)) or would have a dispropor-
tionate patient percentage of at least 35 percent 
(as so determined) if the hospital were a sub-
section (d) hospital (or, a percentage of inpa-
tient days consisting of items and services fur-
nished to individuals entitled to benefits under 
part A that exceeds 85 percent of all such days) 
that is either a critical access hospital, a sole 
community hospital (as defined in section 
1886(d)(5)(D)(iii)), or a medicare-dependent, 
small rural hospital (as defined in section 
1886(d)(5)(G)(iv)); 
‘‘(B) a large subsection (d) teaching and 
tertiary hospital with more than 200 beds that 
as of, or subsequent to July 1, 2020, has an av-
erage Medicare case mix index of at least 1.5, 
an intern and resident-to-bed ratio of at least 
0.25 percent (or at least 150 full-time equiva-
lent interns, residents, and fellows), and is ei-
ther a public hospital with a disproportionate 
patient percentage of at least 35 percent (as de-
termined by the Secretary under section 
1886(d)(5)(F)(vi)) or a nonprofit hospital with 
VerDate Sep 11 2014 
22:27 Apr 07, 2025
Jkt 059200
PO 00000
Frm 00009
Fmt 6652
Sfmt 6201
E:\BILLS\H2590.IH
H2590
ssavage on LAPJG3WLY3PROD with BILLS
a disproportionate patient percentage of at least 
45 percent; or 
‘‘(C) a small subsection (d) urban safety 
net hospital (as determined by the Secretary) 
with less than 200 beds that is deemed to be 
a disproportionate share hospital under section 
1923(b). 
‘‘(3) INNOVATIONS ADDRESSING MENTAL AND 
PHYSICAL HEALTH COMORBIDITIES.—The term ‘in-
novations addressing mental and physical health 
comorbidities’ means innovations implemented by an 
eligible hospital that seek to promote holistic care 
and treatment of an applicable individual’s co-occur-
ring mental and physical health comorbidities, sup-
port early detection of such comorbidities, or prevent 
their onset, including the following: 
‘‘(A) Implementation of interdisciplinary 
integrative coordinated care team models, in-
cluding those that utilize mental health emer-
gency department in-reach staff (and other 
emergency-department interventions), care co-
ordination staff and social services support, and 
clinic-based services. 
‘‘(B) Integration of mental health services 
into medical homes, coordinated care organiza-
VerDate Sep 11 2014 
22:27 Apr 07, 2025
Jkt 059200
PO 00000
Frm 00010
Fmt 6652
Sfmt 6201
E:\BILLS\H2590.IH
H2590
ssavage on LAPJG3WLY3PROD with BILLS
tions, accountable care entities, and in-home 
services. 
‘‘(C) Incorporation of mental health and 
social risk screening into medical screening, 
particularly in child and adolescent populations. 
‘‘(D) Preventing adverse impacts on men-
tal health resulting from physical health treat-
ments or medications, or on physical health re-
sulting from mental health treatments or medi-
cations, through cross disciplinary provider edu-
cation, quality metrics, and other mechanisms. 
‘‘(E) Improvements in electronic health 
records and other technology platforms or net-
works to capture, track, and monitor mental 
and physical health treatments and medications 
provided across care settings and otherwise fa-
cilitate care coordination. 
‘‘(F) Piloting of reimbursement modifica-
tions that utilize site-neutral payments and that 
address conflicts and disincentives related to 
chronic care management and behavioral health 
management and differential treatment of inpa-
tient and outpatient settings. 
‘‘(G) Mitigating the incidence of admission 
and readmission into psychiatric inpatient set-
VerDate Sep 11 2014 
22:27 Apr 07, 2025
Jkt 059200
PO 00000
Frm 00011
Fmt 6652
Sfmt 6201
E:\BILLS\H2590.IH
H2590
ssavage on LAPJG3WLY3PROD with BILLS