Navigating the Complex Landscape of Behavioral Health in Value-Based Care
Leadership Health Care (LHC), a Nashville Health Care Council program for emerging leaders, Cohorts provide the participants an opportunity to engage in a peer mentoring program facilitated by an experienced healthcare executive. Throughout six cohort sessions, participants discuss substantive topics around a common focus area to enhance their knowledge and leadership skills.
Navigating the Complex Landscape of Behavioral Health in Value-Based Care
In a recent discussion, Clay Phillips, SVP of Strategy and Managed Care Summit BHC, Janice Maurizio, VP of Behavioral Health Programs at BCBST, and Marjorie Morrison, Founder at Psych Hub, explored the evolving landscape of behavioral health in value-based care (VBC). As healthcare increasingly transitions to value-based models, the integration of behavioral health presents both a critical opportunity and a formidable challenge.
Mental Health Parity and Value-Based Care
One of the central topics was mental health parity, a long-debated issue requiring mental health coverage to be on par with physical health services. Parity rules mandate that mental health services receive equal treatment in terms of coverage, but the real challenge lies in applying this principle in practice. It was emphasized that parity is tricky. On paper, it looks simple—equal copays and coverage limits—but it gets complicated when you look at the frequency of care. For instance, a cardiologist may see a patient every six months, while a therapist might need to meet weekly. The copay burden is far heavier for behavioral health patients, and that’s an issue we still haven’t fully addressed.
To tackle these challenges, the cohort discussed potential solutions. Risk-sharing models were highlighted as a way to incentivize payors and providers to share financial risk, helping to alleviate the cost impact of frequent behavioral health visits. Innovative payment models that blend fee-for-service with outcome-based reimbursements were also proposed, aligning provider incentives with patient outcomes rather than just service volume. Additionally, the importance of accessible mental health support was underscored, with suggestions for digital therapy sessions and peer support programs to ease the burden of in-person visits.
The Education Gap in Behavioral Health
Another key issue raised by the panel was the role of education in improving behavioral health outcomes. Both healthcare providers and patients require more education to navigate treatment options effectively. The cohort discussion highlighted that many nurses and healthcare professionals lack specialized training in behavioral health, which presents challenges when managing mental health crises. Organizations are now providing additional training to ensure nurses can respond appropriately to behavioral health emergencies.
The importance of education about medication compliance and side-effect management was discussed, noting that many patients stop taking medications prematurely due to a lack of immediate improvement. Organizations are focusing on educating patients more proactively, with companies like Psych Hub reaching out through consumer-friendly platforms to bridge this knowledge gap.
The Role of Technology and Access
While technology has been promoted as a solution for many healthcare challenges, the adoption of behavioral health apps and digital platforms remains inconsistent, particularly in rural areas. Urban regions have embraced these tools more widely, while rural communities often lack the infrastructure to support them. Even where technology is available, getting patients to engage with it continues to be a challenge.
We need to rethink how healthcare providers reach patients. As fewer people answer phone calls, healthcare systems are exploring safer ways to communicate, such as through text messaging that protects patient health information. Meeting patients where they are, whether through digital tools or alternative outreach methods, remains a crucial priority.
The growing role of AI and other digital innovations in bridging gaps between patients and providers was discussed but cautioned that the market is flooded with apps, making it difficult to determine which ones deliver meaningful results.
Building Relationships and Trust
Ultimately, the success of behavioral health care often hinges on the strength of the patient-provider relationship. Even the most effective evidence-based practices and clinical measurements can fall short if the connection between therapist and patient isn’t strong. A positive, trusting relationship in the initial session is key to encouraging patients to continue their therapy. Many patients attend only one therapy session, so fostering trust from the outset is essential to improving long-term outcomes.
What The Future Holds
The LHC Operations Cohort discussion emphasized that the future of behavioral health in value-based care requires a multifaceted approach. From addressing the complexities of mental health parity to enhancing education and leveraging technology, the path forward will involve collaboration across sectors. The insights shared by Phillips, Maurizio, and Morrison underscore the ongoing need to evolve how behavioral health is integrated into the broader healthcare landscape, ensuring patients receive the care they need when they need it.
By tackling these challenges head-on, the healthcare community can build a more inclusive and effective system that benefits both providers and patients, ultimately leading to better outcomes in value-based care.
The Next Generation of Healthcare Leaders
Leadership Health Care’s mission is to cultivate talented healthcare professionals into the industry leaders of tomorrow. LHC aims to provide young professionals with ongoing opportunities to develop their knowledge of the healthcare industry through educational events and networking opportunities. Fill out this form to learn more about LHC.