The bulk of state Medicaid programs cover services to treat substance use disorders (SUDs) and outpatient services, but few cover crisis care services. That’s according to a new report by the Kaiser Family Foundation (KFF), which included survey responses from 45 states about their health benefits. In the survey, KFF provided state Medicaid officials with […]
Category: Medicaid
Nonprofit health plan Point32Health is prioritizing integrated care and value-based contracting as part of its overall behavioral health strategy. The payer is doing this through partnerships and in-house integration between mental and physical health providers. Specifically, Point32Health has inked value-based contracts focused on autism and substance use disorder (SUD) care, and it plans to expand […]
A bipartisan group of senators has called out large payers for their mental health “ghost networks,” which provide an inaccurate list of in-network providers. “Ghost networks” often list providers no longer in-network, accepting patients, or having closed their practice. The lawmakers noted that ghost networks could lead to mental health access issues and make it […]
The U.S. Centers for Medicare & Medicaid Services (CMS) is looking to streamline primary care-specialist care integration, which could make it easier for behavioral health providers to get paid. Medicaid programs may now directly pay consulting providers for interprofessional consultations, even when a patient is not present. CMS informed state health officials of the new […]
Changes to Medicaid in 2022 repositioned behavioral health’s relevance to the program — and its importance to the behavioral health industry. Medicaid is the single-largest payer of mental health services in the nation. And changes to the public health plan for vulnerable populations may further alter the business landscape, industry insiders believe. Medicaid, a collaboration […]
State Medicaid programs continue to expand behavioral health benefits, especially for specific high-needs populations. Several states have rolled out new behavioral health benefits or enhanced existing ones. All the while, no states have plans to restrict behavioral health benefits during fiscal year 2023, according to a new survey of state Medicaid leaders from the Kaiser […]
After years of reimbursement uncertainty, the digital therapeutics industry is beginning to see newfound clarity. Within the last year, digital therapeutics, which are evidence-based treatments delivered through software interventions to treat or manage a condition, have made inroads with both commercial insurers and Medicaid. Earlier this year, state Medicaid programs in Massachusetts and Oklahoma announced […]
The U.S. Centers for Medicare & Medicaid Services (CMS) is considering creating the first national directory of health care providers and services. The agency floated those plans in a Wednesday announcement. Such a move could have major implications for the notoriously fragmented behavioral health industry. CMS is pitching the directory as a way to help […]
Autism treatment provider Cortica Inc. has entered into a new value-based care payer arrangement that may accelerate the development of similar deals in the future. Insurer Point32Health now has an outcome-focused value-based care agreement with San Diego-based Cortica for members enrolled in Point32Health Massachusetts’ Medicaid and commercial health plans. “It’s these kinds of groundbreaking collaborations […]
The U.S. Department of Health and Human Services (HHS) is looking to bolster the behavioral health workforce and test out new payment models in effort to improve mental health parity and access. It’s part of HHS’ recently released roadmap, which gives guidelines about integrating mental health and substance use care into whole-person care. The roadmap […]
Sign up
Receive industry updates and breaking news from Behavioral Health Business