The behavioral health industry often views accountability and transparency as challenges instead of opportunities. This approach has hurt the over 57 million Americans living with mental illness. Health plans need reliable partners to make real change. It’s time for both providers and health plans to step up.
As founders of new behavioral health organizations, we see accountability as essential for improving a system that frequently lets patients down. We launched our organizations because we are tired of seeing our loved ones not receive the care they truly need. We believe in measurement-based care (MBC) and value-based models. This means that care should not just be accessible but should actually lead to real results. While some providers resist these standards, we think they are crucial for making a difference in people’s lives.
Providers must take responsibility and lead the charge. Although some progress has been made, providers who overlook measuring outcomes or shy away from value-based care can unintentionally contribute to the very issues they aim to resolve.
Statistics Reveal a Problem
The statistics paint a concerning picture. According to Blueprint’s data, only 20% of patients receiving psychotherapy find it effective. This is why many patients stop seeking care—only 36% of therapy patients continue after their fourth session. We are losing too many individuals who simply need help. Many providers still rely on outdated practices, and we feel a duty to change this pattern.
It’s disheartening that so many people bravely seek help but do not see the improvements they deserve. Prioritizing volume over value not only impacts patients but also affects health systems and payers relying on effective care. Providers must address the root issues—like inconsistent performance standards and ineffective measurement methods—to ensure mental health care truly benefits individuals.
The Need for Accountability
Some health plans are leading the way by shifting towards value-based care. They are showing that focusing on accountability for outcomes can improve patient results and reduce long-term costs.
However, we need more payers to join this movement and embrace meaningful changes centered around outcomes. How can we set industry-wide standards for measuring success? We propose two essential elements:
1. Establish Consistent Standards for MBC
Currently, fewer than 20% of behavioral health providers use MBC, but those that do see better outcomes. MBC allows for tracking patient progress and making real-time treatment adjustments, improving care quality and efficiency. Some worry that outcome measurement adds more complexity, but with the right approaches and training, clinicians are likely to welcome MBC.
We envision a future where industry-wide MBC standards prevail, starting with health plans aligning their expectations. In recent efforts, the National Quality Forum (NQF) announced an initiative called Aligned Innovation that aims to create standard outcomes for behavioral health across various groups.
To ensure effectiveness, we suggest measurements be:
- Short, easy to understand, and repeatable.
- Relevant to different behavioral health conditions, capturing factors like distress and quality of life.
- Useful for patients, clinicians, and payers alike.
2. Align Incentives with Outcomes
A report from Evernorth highlights how value-based reimbursement can enhance patient outcomes and reduce costs in behavioral health. Achieving this shift requires collaboration between payers and providers to define quality care. Clear accountability and robust measurement standards are vital for closing the gaps in our current system.
Value-based contracts can be mutually beneficial. They encourage high-quality care, which means better outcomes for patients, reduced costs for payers, and financial rewards for effective provider models. Incentives should drive meaningful improvements, pushing providers to help patients recover faster instead of keeping them in prolonged care without additional benefits.
Over time, we expect to see these value-based partnerships evolve, leading to more effective collaboration between innovative payers and provider organizations.
A Path Forward for Health Plans
What we advocate for now might have seemed impossible just a few years ago. Today, major health plans in the U.S. are beginning to take the lead. We are witnessing more momentum towards standardized outcome measures and broader value-based agreements.
Yet, much work remains. The behavioral health industry has long lacked the accountability needed to provide quality care. Provider organizations are proving every day that when accountability becomes the standard, we not only benefit patients but also strengthen the system as a whole.
It’s time to take action. Together, we can create a system where outcomes matter, and every patient leaves their treatment better off than before.
