Melinda Buchheit, MSPrimary Care: The Foundation of Montana’s Behavioral Health System
Bozeman, Mont. (February 13, 2024) – Today, the Montana Healthcare Foundation released a new issue brief that analyzes the role of primary care providers in addressing Montana’s behavioral health needs. As Montana seeks to build a better behavioral health system, the findings in this report underscore the need to ensure that primary care providers are well-equipped and supported to prevent and treat mental illness and substance use disorders.
Media attention and policy discussions have tended to focus on the role of specialty behavioral health providers and services in addressing what is often termed a behavioral health “crisis” in Montana. This analysis of Montana Medicaid claims data shows that more than half (54%) of Medicaid members with behavioral health needs receive care exclusively from primary care providers, and 81% of the Medicaid population that accessed behavioral health care received at least some of those services from a primary care practice.
The analysis – which examined Medicaid behavioral health claims for youth and adults – found that the role primary care plays is central to Montana’s behavioral health system, even for complex behavioral health conditions. For example, primary care providers deliver nearly half (49%) of all treatment for substance use disorders and one-third (32%) of care for people with serious mental illness.
The Integrated Behavioral Health model is an important strength of Montana’s primary care system. This model brings behavioral health professionals into the primary care setting, where the providers work as a team to screen individuals for behavioral health needs and provide assessment, treatment, and referral (if needed), generally as part of the same visit.
Through its Integrated Behavioral Health Initiative, the Montana Healthcare Foundation has provided grants and training to 68 primary care practices to support start-up costs and implementation of the IBH model. Roughly 80% of Medicaid-covered adults and youth now have access to integrated care in a practice funded to implement the model. In 2022, of the 75,900 Medicaid members who received behavioral health care in a primary care office, nearly half (36,650) were seen in a practice implementing the IBH model.
The Montana Healthcare Foundation commissioned the report as part of its ongoing work on behavioral health and primary care.
