Covering 25% of all mental health treatment services, Medicaid is “the largest payer” in the U.S. behavioral health system. But in one respect, that is a misnomer—in reality Medicaid is a collection of 50 payers with 50 separate partnerships between each state and the federal government. With 50 unique ways of providing health care to vulnerable populations, the Medicaid programs are as diverse as the states themselves. Familiarity with your local Medicaid system can help you find opportunities for getting involved in state initiatives and for building partnerships with other stakeholders. Knowing where to expect change is a . . .