Ready for Reform: Behavioral Healthcare in Massachusetts

Prepared in partnership with the Blue Cross Blue Shield of Massachusetts Foundation

Massachusetts has long been a national leader in state-level healthcare reform. In 2006, the state enacted a landmark coverage expansion that became the model for the Affordable Care Act. It has also been a leader in broadening mental health parity laws, implementing innovative cost control measures in its Medicaid program, and developing innovative delivery system and payment reforms through its long-standing Section 1115 demonstration waiver. As a result, Massachusetts has boasted the lowest uninsured rate of any state in the nation for more than a decade and ranks highly among states on both physical and behavioral healthcare quality and access measures.

Despite these efforts, there remain critical gaps in access to needed behavioral healthcare services (including mental health and substance use disorder-related services) in the commonwealth. Consumers consistently report long waits for appointments, lack of inpatient bed availability and difficulty finding providers who take insurance, among other challenges. In 2018, 38.7 percent of adults who had sought mental health and/or substance use disorder care in Massachusetts in the previous 12 months reported unmet need for such care.

In a new report published in partnership with the Blue Cross Blue Shield of Massachusetts Foundation, Manatt Health provides a call to action for Massachusetts policymakers and stakeholders to significantly improve consumer experience in behavioral healthcare access, coverage and quality in the commonwealth regardless of the consumer’s age or insurance status. The report provides a new, whole-person-oriented vision for behavioral healthcare, an organizing framework, and short-term and long-term recommendations to achieve reform. This new vision for behavioral healthcare in Massachusetts addresses some of the most pressing challenges impacting how behavioral healthcare is delivered in the state today, including barriers to accessing and navigating the behavioral healthcare continuum, inadequate coverage of behavioral healthcare services across payers, workforce shortages and capacity issues, unnecessary regulatory burden and redundancy, fragmented administrative and payment functions, lack of monitoring and accountability for behavioral health outcomes, barriers to behavioral health information sharing, and lack of affordable housing options. To provide a locus of responsibility, accountability and transparency for addressing these systemic issues, the vision also calls for the state to establish a Behavioral Health Redesign Team, which would be responsible for developing longer-term policy recommendations.

Click here to download the full report, executive summary and companion chartpack.

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