Earlier this month, the Centers for Medicare and Medicaid Services (CMS) quietly released its long-awaited Behavioral Health Strategy, signaling a renewed focus on equity, expanded access, and the development of high-quality payment models for behavioral health care across the United States. The strategy comes at a pivotal time as the nation faces growing behavioral health needs, a persistent shortage of qualified providers, and ongoing barriers to care for millions of Americans. CMS outlined five central goals in its strategy: improving equity and quality in behavioral health care, boosting access to substance use disorder programs, enhancing pain treatment and management, expanding access to mental health services, and leveraging data to guide service delivery and policy development. Each of these goals reflects a broader commitment to addressing the systemic challenges in behavioral health care, ensuring that all Americans have access to effective, evidence-based treatment regardless of geography, income, or background.
A Strong Focus on Equity and Quality
At the heart of CMS’s strategy is a commitment to integrating health equity into both care delivery and payment models. For individuals with behavioral health needs, disparities in access and outcomes have been long-standing issues. CMS stresses that incorporating equity measures is critical to improving patient care and outcomes. The strategy highlights the role of technology and telehealth in bridging gaps in access, particularly for rural or underserved communities, while emphasizing the importance of outreach and patient education in expanding engagement and awareness.
Quality improvement is another central focus. CMS pointed to the National Quality Forum’s work on acute and chronic pain management as well as substance use disorder programs as benchmarks for improving care quality. By aligning behavioral health programs with nationally recognized quality measures, CMS aims to ensure that interventions are not only accessible but also effective, safe, and patient-centered.
Expanding Access and Recovery for Substance Use Disorder
Improving prevention, treatment, and recovery services for individuals with SUD is a key goal of the CMS strategy. The agency recognizes the barriers that often prevent patients from accessing care, including financial constraints, lack of providers, stigma, and logistical challenges. CMS plans to address these issues by supporting innovative payment models that incentivize states and providers to deliver comprehensive substance use disorder programs.
One specific initiative under this goal is the creation of a new path under Section 1115(a) of the Social Security Act, which allows states to demonstrate and test flexible approaches to improve the continuum of care for SUD patients. These models provide states with the flexibility to implement innovative substance use disorder programs that can address gaps in treatment availability, continuity of care, and long-term recovery support.
Workforce expansion is another critical component. According to the U.S. Health Resources and Services Administration (HRSA), there were just over 91,000 addiction treatment counselors in the country as of 2017—a number insufficient to meet current demand. CMS’s strategy emphasizes the need to recruit, train, and retain more professionals to deliver high-quality substance use disorder programs, including developing incentives, training programs, and tools to enhance the clinical skills of existing and new providers.
Enhancing Pain Treatment and Management
Pain management—both acute and chronic—is closely linked to behavioral health outcomes, particularly given the overlap with substance use and mental health disorders. CMS aims to expand access to evidence-based pain treatment and management strategies through guidance to states and potential coverage pathways for innovative therapies.
Training and workforce development are key elements of this goal. By equipping clinicians with tools and education to better diagnose and manage chronic pain, CMS seeks to reduce reliance on ineffective or potentially harmful treatments while improving patient quality of life. Integrating pain management with substance use disorder programs ensures that patients receive coordinated care that addresses both physical and behavioral health needs.
Increasing Access to Mental Health Care
Access to behavioral health services has long been a significant challenge in the United States. According to the National Council for Mental Wellbeing, 42% of Americans report that cost or inadequate insurance coverage is the top barrier to accessing care. CMS is prioritizing the detection and management of mental health conditions through coordinated efforts with primary care and specialty providers, ensuring that patients receive timely, appropriate interventions.
Community-based services play a critical role in this strategy. CMS is investing heavily in programs that provide support beyond traditional clinical care, including housing, peer support groups, and social engagement opportunities. These investments aim to address the social determinants of health that often exacerbate behavioral health conditions. Recent federal investments, such as the $300 million allocated to two Certified Community Behavioral Health Clinics (CCBHCs), demonstrate the administration’s commitment to expanding mental health care and substance use disorder programs.
The strategy also highlights several supporting initiatives, including Medicaid community-based crisis services, pediatric-focused mental health programs to improve awareness of Medicaid and CHIP coverage, and the integration of certified community behavioral health clinicians into care delivery. In 2021, the Biden Administration awarded $15 million in planning grants to 20 states to implement mobile crisis intervention services for Medicaid recipients, further enhancing access to urgent behavioral health support, including substance use disorder programs.
Leveraging Data for a More Effective Future
A cornerstone of CMS’s strategy is the use of data to improve behavioral health outcomes. By taking a more data-driven and outcomes-focused approach, the agency intends to evaluate Medicare, Medicaid, CHIP, and private insurance programs to identify gaps, monitor equity, and measure the quality of care delivered.
Data is also being used to generate research and evidence that can inform policy and clinical practice. Existing tools, such as Medicaid SUD data releases and the Medicare Disparities Mapping Tool, provide valuable insights into areas of need, population trends, and service utilization. CMS’s focus on using data to improve substance use disorder programs represents a shift toward proactive, informed decision-making that can better tailor interventions to patient populations and community needs.
Looking Ahead
CMS’s new Behavioral Health Strategy represents a significant step forward in addressing the complex and evolving behavioral health landscape in the United States. By prioritizing equity, expanding access to mental health and substance use disorder programs, enhancing pain management, and leveraging data to guide care, the agency is laying the groundwork for a more responsive and effective system.
For providers, policymakers, and patients alike, these initiatives signal an opportunity to rethink how behavioral health services are delivered and financed. With continued focus on innovation, workforce development, and community-based care, the strategy sets a clear path toward improving health outcomes for millions of Americans and ensuring that behavioral health care is both accessible and high-quality.
