About 20 percent of all Americans live with a behavioral health condition, but only half of this population receives treatment - with direct consequences that include poor physical health outcomes, increased health care costs, and reduced quality of life and life span.

Barriers to obtaining behavioral health treatment are most evident in populations receiving Medicare, Medicaid, and Marketplace plans. Behavioral health care providers serving individuals enrolled in these plans are more likely to experience challenges around reimbursement and training, which disincentivizes participation.

The Centers for Medicare & Medicaid Services and the Substance Abuse and Mental Health Services Administration asked the National Academies to convene an expert committee to examine current challenges in ensuring broad access to evidence-based behavioral health care services through Medicare, Medicaid, and Marketplace programs and propose strategies to address those challenges.

Table of Contents

Front Matter Summary 1 Introduction 2 Behavioral Health Needs in the United States 3 The U.S. Behavioral Health Care System 4 Factors Contributing to the Expansion and Recruitment of Behavioral Health Providers Serving Medicare, Medicaid, and Marketplace Beneficiaries 5 Enhancing Workforce Retention in Medicare, Medicaid, and Marketplaces: Key Factors at Play 6 Innovative Infrastructure: Balancing Support and Challenges for the Behavioral Health Workforce in Medicare, Medicaid, and Marketplace 7 Recommendations Appendix A: Committee and Staff Biographies Appendix B: Disclosure of Unavoidable Conflict of Interest Appendix C: Chapter 3 Tables Appendix D: Public Meeting Agendas Appendix E: Exploring Strategies to Improve Access to Behavioral Health Care Services through Medicare and Medicaid: Proceedings of a Workshop-in Brief Appendix F: Recommendations and Conclusions Matrix