The Centers for Medicare & Medicaid ServicesCenters for Medicare and Medicaid quietly released its Behavioral Health Strategy earlier this month with an emphasis on equity and access to care and new high quality payment models.
The agency laid out five main goals in its strategy; improving equity and quality in behavioral health care, boosting access to substance use disorder programs, improving pain treatment and management care, expanding access and quality to mental health services and using data to guide services.
A focus on equity and quality
CMS stressed the importance of incorporating health equity into both care and payment models for individuals at-risk behavioral health needs. The goal also highlighted the potential for technology and telehealth to help expand access to care, as well as the role of outreach and education in meeting the needs of more patients.
Boosting quality measures in pain management and behavioral health was another critical component to this goal. The agency pointed to the National Quality Forum’s focus on acute and chronic pain management and SUD, as well as its quality measures inventory, as supporting activities.
Improving prevention, treatment recovery access for substance use disorder
The second goal pledged to improve the care experience for individuals with substance use disorder and help break down the barriers to treatment. Similar to the first goal, the agency said that innovative payment models would be a part of the plan.
CMS has already been working to support new payment models. In fact, CMS created a new path “under the authority of section 1115(a) of the Social Securities Act (Act) for states to demonstrate and test flexibilities to improve the continuum of care for beneficiaries with substance use disorder.”
Expanding the substance use disorder workforce was a key part of this goal. As of 2017, the US Health Resources and Service Administration (HRS) reported there were just over 91,000 addiction treatment counselors.
A better way to treat and manage pain
Building on its substance use disorder goals, the agency emphasizes the need to improve care for patients with acute and chronic pain. CMS pitches expanding access to evidence-based pain treatment via guidance to states and exploring potential coverage pathways.
The agency also calls for an expanded workforce and new training tools to help clinicians diagnose and treat chronic pain.
Creating an avenue for behavioral care access
Access to mental health resources has been a major issue in the US for some time. In fact, the National Council for Mental Wellbeing reports that 42% of the US population named cost or poor insurance coverage as the top barrier to accessing behavioral healthcare.
CMS is prioritizing detection and management of mental health conditions via coordinated care with primary and specialty providers.
The agency is also investing heavily into community-based services, including support groups, housing and social groups are key to the agency’s goals.The Biden Administration recently invested $300 million in two Certified Community Behavioral Health Clinics (CCBHCs) as part of its efforts to expand access to mental health and SUD care.
The agency pointed to its Medicaid community-based crisis service, its pediatric focused mental health initiative focused on giving information about Medicaid and CHIP behavioral health coverage, as well as the integration of certified community behavioral health clinicians into care delivery as activities supporting this goal. In December 2021 the Biden Administration awarded $15 million in planning grants to 20 states to support community-based mobile crisis intervention services for Medicaid recipients.
The data revolution’s part in care for the future
The agency also plans to take a more data driven and outcomes based approach to behavioral health in the future. CMS plans to evaluate Medicare, Medicaid and Children’s Health Insurance Program and private insurance through data. Part of those evaluation metrics will be based on equity and quality.
In the plan CMS highlighted using data to help evidence generation and research, with the goal of increasing health outcomes.
The agency currently releases Medicaid Substance Use Disorder data and a tool for mapping Medicare disparities.
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