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States Report Disparities in Medicaid Behavioral Health Coverage

Nearly 15 percent of adults with a behavioral health condition lack health insurance, according to the Institute for Medicaid Innovation (IMI).

New results from the IMI’s annual Medicaid managed care survey highlight trends in behavioral health care coverage and variation in financing models for behavioral health care across states.

When asked about top policy barriers to providing behavioral health services, states cited:

  • fragmentation in Medicaid funding and managed care contracting for physical and behavioral health services; and
  • 42 CFR Part 2 limitations on sharing substance use disorder treatment information.

The results also outline variation in state financing models for behavioral health care coverage. At the beginning of 2017, 11 states continued to carve out behavioral health coverage from Medicaid managed care plans.

Based on these findings, IMI recommends states promote the use of collaborative care models that integrate physical and behavioral health; conduct research on such models’ effectiveness; and improve reimbursement for services in these models.

The IMI report also includes clinical, research, and policy priorities for advancing behavioral health care in Medicaid.

Contact Senior Director of Policy Erin O’Malley at eomalley@essentialhospitals.org or 202.585.0127 with questions.

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About the Author

Kelcie Jimenez is a state policy analyst at America's Essential Hospitals.

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