Center for Financing Reform & Innovation (CFRI)
Learn about behavioral health financing mechanisms, options, and innovations through CFRI reports and webinars.
What is CFRI?
The Center for Financing Reform and Innovation (CFRI) is a SAMHSA contract that seeks to understand financing mechanisms of behavioral health care to identify opportunities, innovations, and challenges to service delivery and access. CFRI provides SAMHSA with a dynamic mechanism to further its leadership and the field on immediate and relevant behavioral health financing and delivery issues.
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In addition, CFRI provides information and analysis to address changes in the organization and financing of behavioral health care as well as guidance on the most effective and efficient use of available resources to meet the prevention, treatment, and recovery support needs of the American public.
What’s New
Financing Peer Recovery Support: Opportunities to Enhance the Substance Use Disorder Workforce
This report provides background history of the development of Peer Recovery (PR), including an overview of the current landscape of PR Programs. This report also provides a description of the variation in peer recovery rates, supervision, credentialing, and substance use disorder vs mental health.
- Download the report: Financing Peer Recovery Support: Opportunities to Enhance the Substance Use Disorder Workforce
- View the webinar (57 minutes)
- Download the webinar slides (PDF | 1.2 KB)
Examining the Use of Braided Funding for Substance Use Disorder Services
This report looks at state and federal laws and policies that encourage braided funding to provide substance use disorder services, best practices for braiding funds, and pathways to sustainability for substance use disorder programs.
- Download the report: Examining the Use of Braided Funding for Substance Use Disorder Services
- View the webinar (1 hour)
- Download the webinar slides (PDF | 1.2 MB)
Medicaid Coverage of Medications to Reverse Opioid Overdose and Treat Alcohol and Opioid Use Disorders
This report provides an update on the present state of coverage, availability of, and access to, medications for treating ongoing alcohol use disorder (AUD) and opioid use disorder (OUD) and reversing an opioid overdose within state Medicaid plans. It also includes examples of innovative efforts to increase access to medications for the treatment of SUDs.
- Download the report: Medicaid Coverage of Medications to Reverse Opioid Overdose and Treat Alcohol and Opioid Use Disorders
- View the webinar (1 hour)
- Download the webinar slides (PDF | 1 MB)
Exploring Value-Based Payment for Substance Use Disorder Services in the United States
This report and webinar explore the use of Value-Based Payment (VBP) models and their potential to improve delivery of integrated and coordinated substance use disorder (SUD) treatment services.
- Download the report: Exploring Value-Based Payment for Substance Use Disorder Services in the United States
- View the webinar (57 minutes)
- Download the webinar slides (PDF | 910 KB)
Coordinated Specialty Care for First Episode Psychosis: Costs and Financing Strategies
This report includes data on the cost of CSC programs; how they are financed; case studies of cost reimbursement methodologies; funding options; trends in costs and financing for CSCs; and data evaluation of Medicaid and private insurance coverage and barriers.
Upcoming Reports & Webinars
The BestPractices4Data series focuses on sharing innovations and best practices for grantees, from grantees. Developed from listening sessions with grantees and government project offices about strategies grantees use to optimize data collection processes, SAMHSA is releasing a series of six (6) issue briefs along with hosting a webinar. The series of issue briefs aims to improve efficiency in the use of grant funds by providing opportunities for grantees to learn from each other. The briefs identify best practices that help reduce costs associated with resource-intensive trial and error attempts typical of new grantees who are trying to figure out the best ways to collect data. Topics for the six (6) issue briefs include:
- Analyze Data to Measure Progress and Tell Your Agency Story
- Establish Data Protocols to Optimize Data Collection
- Hire Effectively for Data Roles
- Incorporate Technology for Data Collection and Reporting
- Manage Data Collection for Multiple SAMHSA Grants
- Understand Unique Data Concern When Working with Tribes
Additional Financing, Payment, and Innovative Resources
- HHS Notice of Benefit and Payment Parameters Final Rule (Final 2024 Payment Notice)
This includes two new essential community provider (ECP) categories that are critical to delivering needed behavioral health care: (1) Substance Use Disorder Treatment Centers and (2) Mental Health Facilities. - 2024 Physician Fee Schedule Final Rule
CMS issued the CY 2024 Physician Fee Schedule (PFS) final rule that announces policy changes for Medicare payments under the PFS and other Medicare Part B payment policy issues. See a summary of key provisions effective January 1, 2024. - The Departments of Labor, Health and Human Services, and Treasury Announce Proposed Rules to Strengthen Mental Health Parity and Addiction Equity Act
The departments of Labor, Health and Human Services and the Treasury announced an important step in addressing the nation’s mental health crisis by proposing rules to better ensure that people seeking coverage for mental health and substance use disorder care can access treatment as easily as people seeking coverage for medical treatments. - Unwinding and Returning to Regular Operations after COVID-19
The Consolidated Appropriations Act, 2023, delinked the end of the FFCRA’s Medicaid continuous enrollment condition from the end of the COVID-19 Public Health Emergency. As a result, the Medicaid continuous enrollment condition will end on March 31, 2023. - CMS Approves California & Kentucky Requests to Provide Essential Behavioral Health Services Through Mobile Crisis Intervention Teams
The Centers for Medicare & Medicaid Services (CMS) approved proposals from California and Kentucky for community-based mobile crisis intervention teams to provide Medicaid crisis services. - CMS Proposes Policies to Expand Behavioral Health Access and Further Efforts to Increase Hospital Price Transparency
The Centers for Medicare & Medicaid Services (CMS) is proposing to expand access to behavioral health services through coverage of intensive outpatient services — an intermediate level of behavioral health care. - Opportunities to Test Transition-Related Strategies to Support Community Reentry and Improve Care Transitions for Individuals Who Are Incarcerated (SMD 23-003) (PDF | 640 KB)
This provides guidance on a new opportunity for states to help increase care for individuals who are incarcerated in the period immediately prior to their release to help them succeed and thrive during reentry. The new Medicaid Reentry Section 1115 Demonstration Opportunity would allow state Medicaid programs to cover services that address various health concerns, including substance use disorders and other chronic health conditions. - Coverage and Payment of Interprofessional Consultation in Medicaid and the Children’s Health Insurance Program (CHIP) (PDF | 261 KB)
This guidance creates an easier path to specialty care for Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries. For the first time ever, state Medicaid and CHIP programs will be able to pay specialists directly when a beneficiary’s primary health care provider asks for advice. - Additional Guidance on Use of In Lieu of Services and Settings in Medicaid Managed Care (PDF | 326 KB)
This provides guidance on an opportunity for states to address health-related social needs for people with Medicaid coverage through the use of “in lieu of services and settings” in Medicaid managed care. This option will help states offer alternative benefits that take aim at a range of unmet health-related social needs, such as housing instability and food insecurity, to help enrollees maintain their coverage and to improve their health outcomes.