Expansion of The Certified Community Behavioral Health Centers (CCBHC) Model Aimed at Transforming Mental Health Care
Exploring the Impact, Expansion, and Future of the CCBHC Model in the U.S.
THE VBP Blog
December 19, 2024 – The United States is facing a growing behavioral health crisis, with millions of individuals lacking access to the care they need. Communities across the nation are grappling with limited resources, fragmented services, and systemic barriers that prevent individuals from receiving timely and effective care. Addressing this crisis requires innovative solutions that prioritize accessibility, integration, and whole-person care. That is where the Certified Community Behavioral Health Centers (CCBHC) model, designed to provide comprehensive and integrated care, comes into play.
In this blog, we’ll explore the origins of the CCBHC model, how it has been implemented, recent expansions, and the benefits it brings to patients, providers, and communities. We’ll also examine what the future holds for this innovative approach to whole-person care. Let’s dive in!
What is the CCBHC Model?
The Certified Community Behavioral Health Centers model attempts to transform how mental health and substance use care in the United States is delivered. Established under the Section 223 Demonstration Program, CCBHCs are designed to provide comprehensive, person-centered services to individuals, particularly those in underserved and vulnerable populations. By integrating mental health, substance use treatment, and primary care, CCBHCs aim to eliminate fragmented care and ensure that individuals receive the support they need in one cohesive system.
The CCBHC model prioritizes accessibility and inclusivity. Centers are required to offer a wide range of services, either directly or through a Designated Collaborating Organization (DCO). These include crisis intervention, outpatient mental health and substance use treatment, care coordination, and primary care screening and monitoring. These services are tailored to meet the needs of diverse populations, and all CCBHC required services must be reasonably accessible to communities identified in the
Community Needs Assessment. This is typically considered to be 30 miles or 30 minutes, whichever is lesser.
A hallmark of the CCBHC model is its sustainable funding structure. Through Medicaid reimbursements, CCBHCs receive prospective payments that support their ability to provide comprehensive services without the financial instability often faced by traditional mental health providers. This funding model helps CCBHCs expand their capacity, hire qualified staff, and invest in technology and infrastructure to deliver integrated care effectively.
CMS Establishes Health Equity Benchmark Adjustment
Another big change is that CMS also established a new Health Equity Benchmark Adjustment (HEBA). It is a third methodology of upwardly adjusting an ACO’s historical benchmark and is designed to incentivize ACOs that serve higher proportions of beneficiaries from underserved communities to enter into or remain in the Shared Savings Program. This aligns with CMS’ goal to expand access to care and improve health equity across the board.
Starting in 2025, an ACO’s historical benchmark will be adjusted using the highest of three values for which it is eligible, either a positive regional adjustment, a prior savings adjustment, or a HEBA. ACOs will be eligible for an adjustment to their historical benchmark based on the number of their assigned beneficiaries enrolled in the Medicare Part D low-income subsidy (LIS) or that are dually eligible for Medicare and Medicaid. This adjustment is intended to provide a stronger financial incentive for ACOs that focus on vulnerable populations, supporting them in achieving savings while maintaining or improving quality.
Inspired by the ACO REACH Model, HEBA allows for only upward adjustments, meaning ACOs won’t face a reduction in their benchmarks. To qualify, ACOs must have at least 15% of their beneficiaries enrolled in Medicare Part D LIS or be dually eligible.
The Expansion of CCBHCs
The Certified Community Behavioral Health Centers (CCBHC) model has gained significant momentum since its inception, driven by federal initiatives to expand access to mental health and substance use care. In 2017, CCBHCs were piloted in eight states to test their effectiveness in improving care delivery and addressing funding challenges for behavioral health providers. Following promising early results, the program has grown substantially, with the federal government actively investing in its expansion.
In 2024, the Biden-Harris Administration announced the addition of 10 new states to the CCBHC demonstration, including Illinois. This increases the total number of participating states to 18. This expansion reflects the program’s success in improving health outcomes, reducing emergency room visits, and providing comprehensive, integrated care for underserved populations. Currently, there are over 500 CCBHCs operating nationwide, supported by grants and funding from the Substance Abuse and Mental Health Services Administration (SAMHSA) and Medicaid. These facilities play a vital role in addressing the mental health crisis, particularly in rural and underserved areas.
As federal funding continues to increase, the CCBHC model can become a cornerstone of behavioral health care in the United States. The program’s emphasis on integrated, accessible, and sustainable care positions it as a potential solution to the nation’s mental health and substance use crises. With ongoing state and federal support, CCBHCs are expanding their reach, ensuring more individuals receive the comprehensive care they need.
Benefits of the CCBHC Model
The CCBHC model offers a wide range of benefits for patients, providers, and communities. The most significant advantage of the CCBHC model is the improved access to comprehensive and integrated care. Consumers benefit from a one-stop system where they can receive mental health and substance use services alongside primary care screenings. This whole-person care approach addresses both physical and behavioral health needs. And it’s proven successful. People Who Receive Care at CCBHCs experienced a 72% reduction in hospitalization and a 40.7% reduction in homelessness.
Additionally, the model prioritizes accessibility, offering same-day appointments and 24/7 crisis response services, which are vital for individuals in acute need. In fact, 29% of CCBHCs added mobile crisis response in 2024, increasing availability in their communities. By expanding access in underserved areas, CCBHCs help reduce health disparities, ensuring more individuals receive the care they need, regardless of their location or socioeconomic status.
Communities can also see significant benefits from the CCBHC model, particularly in rural and underserved areas where behavioral health resources are often limited. By addressing social determinants of health, such as transportation barriers and housing instability, CCBHCs play a crucial role in improving overall community well-being. 91% of CCBHCs proactively assist clients with finding or maintaining stable housing, and 83% provide services on-site in one or more schools, childcare or other youth-serving settings. This shows a whole-person approach, as well as a shift to meeting people where they are to provide care, thereby increasing access to care. By delivering better care to patients, creating a supportive environment for providers, and strengthening community health, the CCBHC model is transforming the way care is delivered.
Advocates Perspective
Certified Community Behavioral Health Centers are a crucial step toward addressing the behavioral health and substance use crises in the United States. By prioritizing accessibility, integrated care, and whole-person support, the CCBHC model has the potential to break down barriers that have prevented individuals from receiving the comprehensive care they need. The model’s focus on underserved and rural communities is especially important in promoting health equity and ensuring that no one is left behind. However, we must continue to push for sustained investment and policy reforms to overcome challenges such as workforce shortages and funding limitations. Expanding the program to more states and addressing social determinants of health will further enhance its impact. Transparency, oversight, and consumer engagement are essential to ensure that CCBHCs remain accountable to the communities they serve. With continued federal and state support, CCBHCs can transform behavioral health care, making it more accessible, effective, and equitable.
Onward!
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About the Author
Fady Sahhar brings over 30 years of senior management experience working with major multinational companies including Sara Lee, Mobil Oil, Tenneco Packaging, Pactiv, Progressive Insurance, Transitions Optical, PPG Industries and Essilor (France).
His corporate responsibilities included new product development, strategic planning, marketing management, and global sales. He has developed a number of global communications networks, launched products in over 45 countries, and managed a number of branded patented products.
About the Co-Author
Mandy Sahhar provides experience in digital marketing, event management, and business development. Her background has allowed her to get in on the ground floor of marketing efforts including website design, content marketing, and trade show planning. Through her modern approach, she focuses on bringing businesses into the new digital age of marketing through unique approaches and focused content creation. With a passion for communications, she can bring a fresh perspective to an ever-changing industry. Mandy has an MBA with a marketing concentration from Canisius College.