Western North Carolina is facing a sustained mental health and substance use crisis. But improving behavioral health access and outcomes will require more than simply increasing the number of providers. It will require building a system that enables clinicians to stay in community practice, supports patients in accessing timely care, and aligns incentives with long-term health outcomes. In a recent conversation with clinician Lissa Carter, we learned about the challenges and opportunities facing mental health providers—and patients—in our region.

Thanks to predicted funding cuts in NC’s Medicaid rebase, NC DHHS implemented a series of sweeping cuts to adjust for the shortfall. Under the announced plan, nearly all Medicaid providers will face rate reductions of 3 percent to 8 percent, while some categories — including nursing homes, hospitals, psychiatric residential treatment facilities and certain ambulatory services — will see steeper cuts of up to 10 percent. 

The reductions will affect services across the board, from personal care and home health to outpatient therapy and hospital care.