Behavioral Health System Financing

Medicaid remains the largest private or public funding source for financing behavioral health services across the United States. Since passage of the Affordable Care Act, State Medicaid programs have undertaken significant changes to their service delivery and payment systems, which has affected behavioral health care in many states through expansion of Medicaid eligibility, movement from fee-for-service to managed care systems, and better integration of physical and behavioral health care for people with serious mental illness and substance use disorders.

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TAC consultants draw on their collective expertise in designing and implementing federal Medicaid policy. They work closely with Medicaid programs to help states provide financially sustainable, evidence-based care for low-income behavioral health service recipients, while using Medicaid as a key strategy for complying with the Supreme Court’s Olmstead (1999) ruling.

Areas of Expertise

  • Medicaid waivers and state plan amendments, including support for states’ negotiations with the Centers for Medicare and Medicaid Services (CMS)
  • Effective and prudent purchasing and performance contracting systems to incentivize quality, cost efficiency, and best practices among service providers
  • Benefit design, value-based purchasing, behavioral health policy development, and implementation of innovative service delivery and financing models
  • Medicaid state plan/waiver implementation through training of leadership and staff, outcome and performance measurement, and quality improvement efforts
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