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NRI’s Executive Director/CEO, Tim Knettler and Sr. Director, Ted Lutterman’s State Mental Health Authorities’ Perspective on NRI Board VP, Lynda Zeller’s Interview on: How Do Medicaid Directors Think About Quality, Budgets, & Innovation?

February 7, 2019

As NRI’s Board V.P., Lynda Zeller’s interview highlights, analytics that focus on Medicaid’s role within larger systems—such as homelessness and State Mental Health Authorities’ (SMHA) systems can provide insights to improve care coordination and population health. Ms. Zeller was recently interviewed by OpenMinds about how Medicaid directors think about the system change and about improving quality and managing budgets. Ms. Zeller provided some insight into innovation at the state level:

“I think we are going to see a move at the Medicaid program level to a real population health model. We’ll see more of a focus on prevention and early intervention. And a focus on specific targeted populations with a subset of strategies for different populations, including addressing the social determinants of health (SDH). This will shift the interest of Medicaid Directors to how systems of care can work better within Medicaid.”

Lynda Zeller raises important points about the increasing importance of analytics to understanding Medicaid’s role in providing essential services to individuals with behavioral health needs. State Mental Health Authority (SMHA) systems provide mental health services to over 7.5 million individuals each year and Medicaid now pays for some or all mental health services to 70% of these individuals.  

NRI data shows that Medicaid is now the largest single funding source of state mental health authority programs, with Medicaid contributing 50% to the $43.5 billion public mental health system overseen by SMHAs. In addition to the Medicaid funding that flows through the state mental health system, Medicaid is expending billions more for mental health and substance abuse services provided outside the State systems (SAMHSA’s studies of Medicaid spending for mental health show that in FY 2014, Medicaid expended $52 billion for mental health services and an additional $7.9 billion for substance abuse services (SAMHSA “Projections of National Expenditures for Treatment of Mental Health and Substance Use Disorders, 2010-2020). Thus Medicaid expended over $30 billion providing mental health service provided outside the SMHA system. Read more

Happy New Year! We hope your 2019 is off to a great start!

January 18, 2019

Recently, two articles by NRI Staff were included in NASMHPD’s Early Intervention in Psychosis (EIP) Virtual Resource Center: 

Interdepartmental Serious Mental Illness Coordinating Committee (ISMICC) December Meeting
November 29, 2018

The Interdepartmental Serious Mental Illness Coordinating Committee (ISMICC) has posted notice of an all-day meeting scheduled for December 11. The public may attend only by webcast or telephone; non-ISMICC members will not be able to attend in person. There will be an opportunity for public comment (limited to two minutes) by telephone at 1PM. The meeting can be accessed via webcast at or by joining the teleconference at the toll-free, dial-in number at 1-800-369-3143; passcode 4784259. 

CMS Announces Short-Term IMD Exclusion Waivers for Serious Mental Illness
November 15, 2018

On November 13, 2018, at a meeting of National Association of Medicaid Directors, the Centers for Medicaid & Medicare Services (CMS) announced a new opportunity for states to seek short-term institution for mental disease (IMD) exclusion waivers, which would allow Medicaid to pay for inpatient mental health services for adults with serious mental illness and children with serious emotional disturbance. NRI executive director, Tim Knettler and senior director, Vera Hollen were in attendance and reported that the announcement was positively received. Learn more