New Report Finds More Montanans Accessing Care for Mental Illness and Substance Use Disorders Because Of Medicaid Expansion

In 2020 alone, 8,600 adults participated in psychotherapy, and 3,300 received treatment for substance use disorders.


Bozeman, Mont. (June 30, 2021) – The Montana Healthcare Foundation released a new report that shows that Montana’s Medicaid expansion program has supported significant improvements in the state’s behavioral health system, increasing its capacity to prevent and treat mental illness and substance use disorders. Moreover, with Medicaid expansion now providing a consistent payment source for substance use disorder treatment services, Montana’s budget for preventing harmful drug and alcohol use has doubled between 2016 and 2020.

“Medicaid expansion is fueling an expansion of Montana’s prevention and treatment system to address longstanding unmet needs, particularly in rural and Tribal communities. This work is just getting started. Turning the tide on addiction, suicide, and mental illness in our state will require steady leadership and dedicated investment for years to come,” said Montana Healthcare Foundation CEO Dr. Aaron Wernham.

“As this new report indicates, substance use disorder treatment services are becoming more widely available and utilized in Montana. Governor Gianforte’s plan to bolster the state’s current efforts to support substance use disorder and behavioral health care through the HEART Initiative will move Montana forward even more,” said Montana Department of Public Health and Human Services Director Adam Meier.

Although Montana consistently has among the highest mortality rates due to drugs, alcohol, and suicide in the nation, this report shows how much progress has been made to improve the behavioral health system and make services available for those who need them.

Key findings of the report include:

  • More people are accessing behavioral health services:
    • In 2020, nearly 34,000 Medicaid expansion enrollees (37%) received a behavioral health service or had a behavioral health diagnosis recorded on a claim.
    • Between 2019 and 2020, Medicaid expansion enrollee use of behavioral health services increased by 28%, and the use of tele-behavioral health increased by 3,112%.
  • Primary care is playing a central role in identifying behavioral health conditions and connecting people to care:
    • Over half of adult Medicaid patients (59%) now receive care in primary care clinics that also provide behavioral health services.
    • Between 2016 and 2020, the proportion of Medicaid expansion enrollees who saw a behavioral health provider for the first time within 30-days of a primary care visit increased from 15% to 29%.
  • New federal funding is supporting the behavioral health system:
    • Increased access to and utilization of behavioral health services by expansion enrollees, combined with a nine-to-one federal spending match for payments, has brought nearly $54 million in new funding to Montana to support the state’s behavioral health system.
  • Expanded resources and capacity for preventing and treating substance use disorders:
    • Medicaid expansion expanded the resources available for substance use disorder prevention and treatment in Montana by over 70% and allowed funding for substance use disorder prevention services to double.
    • The number of state-authorized substance use disorder treatment provider service locations more than doubled between 2016 and 2021. In addition, the number of providers waivered to prescribe buprenorphine for opioid use disorders increased by over 700% between 2017 and 2021.

Medicaid provides Montanans with low-income access to physical and behavioral health care services based on their medical needs and life circumstances. It also provides access to primary care services, a crucial resource for early detection and treatment of behavioral health concerns. Montana expanded Medicaid in 2016, increasing access to behavioral health care services by providing coverage for over 90,000 people and providing funding that has allowed the behavioral health system to grow and add new services to the benefit of all Montanans.

Medicaid in Montana Issue Spotlight: The Critical Role of Medicaid Expansion in Supporting Montana’s Behavioral Health System was produced by Manatt Health.