Collaborative Care growth, evidence, and the Medicaid gap

This article was originally published at Collaborative Care growth, evidence, and the Medicaid gap

The Collaborative Care Model has moved from pilot to mainstream faster than almost any care model in behavioral health. A May 2025 Milliman analysis, commissioned by Path Forward and the American Psychiatric Association, found that use of the model among commercially insured patients grew 27-fold between 2018 and 2023, from 2.2 to 58.8 patients per 100,000. A February 2026 report from Shatterproof and the Bowman Family Foundation documented a 26-fold increase, from 12 to 317 patients per 100,000 people diagnosed with a mental health condition, between 2018 and 2024.

The evidence base behind that growth is deep: more than 90 randomized controlled trials support the model’s effectiveness for depression and anxiety. Path Forward, drawing on Meadows Mental Health Policy Institute analysis, estimates that Collaborative Care could prevent approximately 14,000 suicide deaths a year if implemented nationwide.

Coverage is the constraint. As of July 2025, 36 state Medicaid programs pay for the Collaborative Care codes, after Colorado and Tennessee joined the list, but rates and provider requirements vary widely. North Carolina raised its reimbursement to 120 percent of Medicare, up from 70 percent, while Massachusetts pays below Medicare.

Workforce is the other limit. Trilliant Health’s 2026 behavioral health report found that fewer than 10 percent of behavioral health providers are psychiatrists; master’s-level clinicians make up most of the workforce, which is exactly the team structure Collaborative Care is designed around.

Federal support continues through CMS’s Innovation in Behavioral Health Model, which offers up to $7.5 million to three state Medicaid agencies, though budget cuts under H.R. 1 put the program’s sustainability in question.

This article was originally published at Collaborative Care growth, evidence, and the Medicaid gap