SAMHSA’s Center for Financing Reform & Innovation Releases New Info on Financing for BH

The Substance Abuse & Mental Health Services Administration’s (SAMHSA) Center for Financing Reform & Innovation (CFRI) has released new information about projects underway, which cover financing mechanisms of behavioral health care that help identify opportunities, innovations, and challenges to service delivery and access.

These products aim to provide guidance on the most effective and efficient use of resources in the prevention/promotion, early intervention, treatment, and recovery support needs of the American public. Through CFRI, SAMHSA is publishing new reports, one-pagers, journal articles, and hosting webinars on a variety of topics providing information and analysis of various topics to address changes in organization and the financing of behavioral health services.

Information about topics includes:

• Financing Peer Crisis Respites in the United States – Peer-operated crisis respites have emerged as a promising approach to provide trauma-informed care to individuals experiencing behavioral health crises. This report and webinar will analyze secondary data to describe organizational characteristics, leadership, and financing of peer-run crisis respites.

• Measurement-Based Care Financing – Measurement based care (MBC) for behavioral health is a clinical process that uses standardized measurements to track a client’s progress over time that inform shared patient-provider treatment planning and decision-making. One significant challenge to the broader adoption of MBC is financing. This report and webinar will provide analyses based on discussions with payers, policy makers, financing experts, and providers and an environmental scan to explore MBC reimbursement options and to identify challenges and potential solutions for increasing use of MBC across diverse community behavioral health care settings.

• Coverage of Selected Behavioral Health Services Among Older Medicare and Medicaid Beneficiaries – This report and webinar will discuss the prevalence of behavioral health conditions among older adults (65+), which is on the rise. Although Medicare, Medicare Advantage, and Medicaid provide coverage for mental health and substance use disorder services, there are gaps in eligibility requirements and additional out-of-pocket costs that differ across payer sources. This project will analyze utilization patterns and disparities for key behavioral health services among older adults enrolled in Medicaid, Medicare, or Medicare Advantage.

• Public Financial Investments in Behavioral Health – In 2020, U.S. behavioral health spending totaled nearly $280 billion, a considerable portion of which came from publicly funded sources such as Medicaid, Medicare, and SAMHSA. However, there is little current data about what types of services are publicly funded, and how the funding is used. This report and webinar will synthesize data on public funding for behavioral health services from 2016-2021 and analyze by service type, state, provider type, and demographic disparities.

• National Gaps in Health Care Access and Health Insurance Among LGB Populations – Findings from the 2023 SAMHSA publication Lesbian, Gay, and Bisexual Behavioral Health: Results from the 2021 and 2022 National Surveys on Drug Use and Health revealed elevated rates of substance use, suicidality, and mental illness among LGB individuals compared to straight individuals. This project investigates whether these findings remain statistically significant when controlling for factors such as age, race, educational attainment, marital status, and financial hardship using propensity score matching. By pooling NSDUH data from 2015 to 2019, this report and webinar will aim to provide a more nuanced analysis of these disparities, and also examine health insurance coverage and barriers to care within this population.

• Funding Strategies of Community-Based Behavioral Health organizations Serving Under-served, Minoritized, Racial, and Ethnic Communities – Community-based organizations (CBOs) provide services to underserved racial and ethnic communities, and generally do not receive federal funding on a recurring basis, potentially exacerbating existing behavioral health disparities. This report and webinar will analyze data on CBOs to describe funding strategies and innovations, and how financing impacts capacity, service provision and sustainability.

In addition, SAMHSA’s CFRI web page contains reports and webinars released earlier on topics such as

• BestPractices4Data: Sharing Innovations and Best Practice for Grantees, from Grantees
• Financing Peer Recovery Support: Opportunities to Enhance the Substance Use Disorder Workforce
• Examining the Use of Braided Funding for Substance Use Disorder Services
• Medicaid Coverage of Medications to Reverse Opioid Overdose and Treat Alcohol and Opioid Use Disorders
• Exploring Value-Based Payment for Substance Use Disorder Services in the United States
• Coordinated Specialty Care for First Episode Psychosis: Costs and Financing Strategies

Information on the release of the new reports and webinar dates will be posted as the projects near completion and promoted through SAMHSA communication channels. Check the SAMHSA CFRI web page for updates