CMS Behavioral Health Strategy

Strategic Pillars

• Focus on person-centered health promotion, early prevention and care opportunities, and integrative care across physical and behavioral health, particularly for children and adolescents
• Drive high value and evidence-based care with a focus on prevention and treatment through value-based payment models and quality measures
• Enhance access to effective technologies such as mobile and digital treatments and tools to enable high quality care and encourage healthy choices that can support wellness 
• Engage and coordinate with states, people, providers, and communities for effective impact
• Coordinate with our federal partners to synergize and align federal programs in an evidence- informed and data-driven manner

Mental Health and Wellness

• Address high-impact conditions such as attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder, dementia, and depression
• Ensure early identification and effective management of developmental and behavioral health conditions through screening for individuals of all ages 
• Reduce suicides and self-harm by enabling early risk identification, appropriate crisis intervention, and timely follow-up for individuals with suicidal ideation and those who have attempted suicide
• Expand access to appropriate evidence-based integrative and holistic health care
• Explore health coaching interventions that can promote mental health and wellness

Substance Use Disorders (SUD) Prevention, Treatment and Recovery

• Increase screening for substance use disorder (SUD) and opioid use disorder (OUD), and access to SUD/OUD treatment
• Streamline access to timely prevention, treatment, recovery services and support, including education, early intervention, screening for risk factors, community support and continuity of care
• Improve crisis care for rapid response & stabilization, furnish effective care, and reliable follow-up
• Support early initiation of SUD/OUD services, such as Buprenorphine/Naloxone initiation in the Emergency Room and support that enable overdose prevention and sustained recovery
• Maximize use of ambulatory care treatment and support options to meet complex care needs
• Support for widespread Naloxone availability to reduce overdose related deaths
• Continue and enhance policies, educate Part D prescribers, and strengthen oversight of opioid prescribing patterns 

Pain Treatment and Management

• Improve clinicians’ awareness of evidence-based pain management modalities
• Promote whole-person care of acute pain to mitigate the risk of persistent or chronic pain and long-term disability 
• Encourage use of covered services and referrals for comprehensive and integrative pain management
• Explore expanded access to appropriate, evidence-based complementary and integrative health practices and treatments, such as chiropractic care, American Indian/Alaska Native (AI/AN) and other traditional healing practices, and acupuncture

Care Efficiencies

• Understand, identify, and resolve barriers to high-value care for people living with and at risk of behavioral health conditions
• Expand care capacity and workforce resilience across care settings through enhanced access to social workers, therapists, counselors, and peer support
• Enhance appropriate prescribing of medications
• Scale accountable care that integrates physical and behavioral health treatment and manages cost
• Reduce fee schedule overpayments that drive overreliance on procedures and tests, and underuse of primary care, behavioral health, and chronic disease management and prevention
• Enhance community understanding of the root causes of mental health issues, suicidality, and substance use disorders (SUD) to enable prevention and more effective, community-based interventions.

Special Populations

• Enable access to care for special focus groups, e.g. 
  • Children & Adolescents, 
  • Older adults & Long-Term Care residents
  • American Indians and Alaska Natives (AI/AN)
  • Persons living in Rural & Island/Territories

Related Documents

• Executive Order 14379 of January 29, 2026: “Addressing Addiction Through the Great American Recovery Initiative” https://www.federalregister.gov/documents/2026/02/03/2026-02249/addressing-addiction-through-the-great-american-recovery-initiative
• The Centers for Medicare & Medicaid Services (CMS), the Substance Abuse and Mental Health Services Administration (SAMHSA), and the Administration for Children and Families (ACF) issued joint guidance to improve coordination between state Medicaid, substance abuse, mental health, and child welfare agencies, with a focus on youth mental health, substance use prevention, and early intervention: https://www.samhsa.gov/sites/default/files/dear-colleague-letter-moud.pdf
• SAMHSA and CMS issued guidance concerning best practices for implementing behavioral health crisis services through Medicaid and CHIP  https://www.medicaid.gov/federal-policy-guidance/downloads/sho25004.pdf
• CMS’s Office of Healthcare Experience and Interoperability conducted the Behavioral Health Human-Centered Design Customer Engagement to understand the barriers to accessing prevention, treatment, and recovery services for substance use disorders (SUD), including mental health and effective pain management. https://www.cms.gov/priorities/burden-reduction/overview/customer-engagement/behavioral-health-engagement