This report shows how much progress has been made to improve behavioral health since Montana implemented Medicaid expansion in 2016. With Medicaid expansion now providing a payment source for behavioral health services, Montana’s system is in the process of a deeply needed transformation. Between 2016 and 2020, Montana’s budget for prevention doubled, and 59% of adults on Medicaid now receive primary care in a practice that also provides behavioral health services. In 2020 alone, over 8,600 adults participated in psychotherapy and nearly 3,300 received treatment for substance use disorders. The report was produced by Manatt Health.