Report Finds Successes, Challenges in State’s Behavioral-health Reforms

BOSTON — The Blue Cross Blue Shield of Massachusetts Foundation released a report offering an early examination of the state’s implementation of the Roadmap for Behavioral Health Reform, a sweeping set of changes aimed at improving access to the outpatient mental-health and substance-use-disorder treatment system for all Massachusetts residents.

Researchers found both successes and challenges since the Roadmap’s launch in early 2023 and identified opportunities to strengthen the multi-year strategy to close critical gaps in community-based care.

The report highlights last year’s rollout of the statewide Behavioral Health Help Line, providing 24/7 access to individuals and families seeking crisis and other services, along with the opening of 27 community behavioral health centers (CBHCs) to serve as one-stop locations for treatment across the state. A third major component of the Roadmap, community-based behavioral-health urgent-care sites providing same-day or next-day outpatient appointments, is also reviewed. The report, prepared by research partner Manatt Health, is based on input from key stakeholders and early implementation data.

Other components of the Roadmap are still getting under way. These include improving integration of behavioral health and primary care — incentivized through new payment models — and improving people’s experience in accessing community-based behavioral-healthcare services, particularly for acute and crisis care, to help reduce unnecessary visits to hospital Emergency Departments.

“This report shows improvement in access to community-based behavioral healthcare as a result of the implementation of the Roadmap, and that is a major step forward given the barriers to care that have existed for so long,” said Audrey Shelto, president and CEO of the Blue Cross Blue Shield of Massachusetts Foundation. “There is broad support for the state’s progress and commitment to the Roadmap and a recognition of the need for more active stakeholder engagement and public education about these reforms moving forward.”

The report outlined opportunities for improvements to the Roadmap implementation and broader system reforms that are crucial to its long-term success. Among its goals are to:

• Improve coordination among state agencies to enhance cross-agency collaboration, ensuring cohesive policy guidance;

• Expand and clarify coverage for services across different insurance plans to ensure broad access;

• Address transportation challenges related to ambulance and law-enforcement dropoffs at CBHCs; and

• Enhance stakeholder engagement and develop a public-awareness campaign to promote key aspects of behavioral health reforms.

Broader system reforms that are required include:

• Strengthening and diversifying the behavioral-health workforce through training programs and payment reforms;

• Advancing data sharing and interoperability by adopting electronic health records and other technology platforms; and

• Supporting community-driven solutions to promote equitable access to behavioral-healthcare services, particularly in marginalized communities.

The report, titled “Massachusetts Roadmap for Behavioral Health Reform: Overview and Implementation Update,” is available online by clicking here.