Medicaid plays a critical role in providing behavioral healthcare. Nationally, Medicaid is the single largest payor for behavioral healthcare. In addition, Medicaid enrollees experience a higher rate of behavioral health disorders-which includes both mental health disorders and substance use disorders-than the general population. In spite of the importance of treating such disorders, many Medicaid enrollees encounter significant barriers when accessing behavioral health treatment. The need for behavioral health services is particularly pronounced in New Mexico-a State that has among the highest rates for suicide and deaths from overdose in the Nation. The Office of Inspector General received a congressional request to look into concerns about behavioral health provider shortages and the availability of care for Medicaid managed care enrollees; these enrollees account for most of New Mexico's Medicaid population.
Open Recommendations
| Recommendation Number | Significant Recommendation | Recommended Questioned Costs | Recommended Funds for Better Use | Additional Details | |
|---|---|---|---|---|---|
| 6035 | Yes | $0 | $0 | ||
| CMS should identify States that have limited availability of behavioral health services and develop strategies and share information to ensure that Medicaid managed care enrollees have timely access to these services. | |||||
| 6036 | No | $0 | $0 | ||
| New Mexico Human Services Department should take steps to expand New Mexico’s overall behavioral health workforce. | |||||
| 6042 | No | $0 | $0 | ||
| New Mexico Human Services Department should take steps to increase adoption of electronic health records and participation in the State Health Information Exchange by behavioral health providers. | |||||
| 6040 | No | $0 | $0 | ||
| New Mexico Human Services Department should work with State partners to strengthen access to broadband in rural and frontier counties. | |||||
| 6039 | No | $0 | $0 | ||
| New Mexico Human Services Department should improve access to transportation for Medicaid managed care enrollees needing behavioral health services. | |||||
| 6037 | No | $0 | $0 | ||
| New Mexico Human Services Department should increase behavioral health providers’ participation in Medicaid managed care. | |||||
| 6045 | No | $0 | $0 | ||
| New Mexico Human Services Department should share information about open-access scheduling and the Treat First Clinical Model and promote expansion. | |||||
| 6038 | No | $0 | $0 | ||
| New Mexico Human Services Department should review its standards governing access to care and determine whether additional standards are needed for behavioral health providers. | |||||
| 6041 | No | $0 | $0 | ||
| New Mexico Human Services Department should expand the use of telehealth to increase the availability of behavioral health services. | |||||
| 6043 | No | $0 | $0 | ||
| New Mexico Human Services Department should identify and share information about strategies to improve care coordination. | |||||
| 6044 | No | $0 | $0 | ||
| New Mexico Human Services Department should expand initiatives to integrate behavioral and primary healthcare. | |||||
