The behavioral health care transformation in Virginia resulted not from one policy change but from multiple changes prior to Medicaid expansion. These changes combined to shape a new behavioral health landscape, with more providers and more treated patients. Virginia's layered approach may inform other states seeking to strengthen their capacity to fight the substance use epidemic, even as new epidemics emerge. The recent policy changes to procedures, outreach, eligibility, coverage, the workforce, and payment have laid the foundation for additional steps in the transformation of behavioral health care, including incorporating improvement in social determinants and addressing disparities.
Keywords: Financing; Medicaid; Public policy issues; funding; reimbursement.