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Medicaid members experience mental health and substance use disorders at significantly higher rates than other populations — yet, amid a nationwide shortage of behavioral health care providers, access to services remains limited. Although Medicaid includes robust behavioral health care benefits and pays for a greater portion of behavioral health care services than any other insurer in the U.S., workforce shortages are a key barrier to access, especially in rural, low-income, and other underserved communities. In some areas, there are as few as three behavioral health care providers per 1,000 Medicaid members. Half of U.S. counties do not have a practicing psychiatrist, and three fourths of counties are either entirely or partially designated mental health professional shortage areas. With upcoming budget pressures on states, finding innovative strategies that expand, extend, and retain skilled behavioral health care providers is critical.

The workforce shortage is driven by a complex set of challenges, including low reimbursement rates and provider wages, burnout and attrition, and costly, non-transferable professional licensing requirements. State Medicaid agencies can play an important role in addressing these issues, strengthening the behavioral health care workforce, and helping their members access care. In this virtual panel hosted by the Center for Health Care Strategies (CHCS), behavioral health care experts from California, Oregon, and Massachusetts explored state Medicaid policy levers to strengthen the behavioral health care workforce. Panelists discussed strategies such as broadening the use of community health workers, peer specialists, lay counselors, and other paraprofessionals; revising payment and reimbursement models; investing in workforce development and provider education; streamlining licensing and accreditation processes; and advancing new care delivery models and technologies.

See the following resources that were referenced during the event:

Agenda

I. Welcome

Speaker: Karla Silverman, MPA, MS, RN, CNM, Associate Director for Women’s Health and Clinical Innovation, CHCS

K. Silverman welcomed attendees and gave opening remarks.

II. Overview of Medicaid Behavioral Health Care Workforce Shortage and Solutions

Speaker: Karla Silverman, CHCS

K. Silverman provided an overview of Medicaid’s role in behavioral health care, the widespread behavioral health care workforce shortage and its impact on health outcomes, and the critical importance of strengthening the behavioral health care workforce that serves Medicaid members.

III. Panel: Innovative Strategies for Addressing the Medicaid Behavioral Health Care Provider Workforce Shortage

K. Silverman moderated a panel discussion exploring emerging strategies and innovations in state Medicaid and behavioral health care workforce efforts.

Speakers: 

  • Emily Eibl, MPP, MBA, Director of Behavioral Health Strategy and Policy, MassHealth
  • Elizabeth Morrison, PhD, LCSW, Co-Creator of the Lay Counselor Academy (California)
  • Jane Zhu, MD, MPP, MSHP, Associate Professor of Medicine, Division of General Internal Medicine and Geriatrics, School of Medicine, Oregon Health & Science University

IV. Audience Q&A

V. Closing

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