The behavioral health industry has experienced a rapid and transformative shift toward telehealth over the past few years. While telehealth has become a dominant force in delivering outpatient behavioral health services, a surprising and important trend has emerged: outpatient behavioral health de novo growth—the establishment of new physical clinics—is continuing robustly. This coexistence of virtual care expansion alongside the building of new brick-and-mortar facilities underscores the evolving nature of behavioral health care delivery in the post-pandemic era.
Telehealth’s Unprecedented Surge in Behavioral Health
The growth of telehealth in behavioral health has been unparalleled compared to other areas of healthcare. According to research by Trilliant Health, behavioral health diagnoses accounted for 57.9% of all telehealth visits in 2021. Prior to the COVID-19 pandemic, telehealth was scarcely used for behavioral health, representing less than 1% of outpatient visits for mental health and substance use disorders (SUD). However, from March to August 2020, telehealth usage soared to 40% of outpatient behavioral health visits, according to Kaiser Family Foundation data.
This rapid adoption was fueled by necessity as lockdowns and social distancing measures disrupted traditional in-person care. The convenience and accessibility of telehealth quickly gained acceptance among patients and providers, helping to address rising behavioral health needs during an unprecedented global crisis.
The Paradox of Outpatient Behavioral Health De Novo Growth Amid Telehealth Dominance
Given the explosion of telehealth, many expected physical clinic expansions to slow or halt. However, outpatient behavioral health de novo growth has remained strong among many leading providers. This dynamic suggests that while telehealth is vital for broadening access, physical locations still play essential roles in providing comprehensive care.
Many organizations recognize that some services cannot be delivered remotely, and others benefit substantially from the human connection fostered by in-person care. The result is a hybrid model, where telehealth and physical clinics operate in tandem to meet diverse patient needs.
Lifestance Health: Balancing Telehealth with Strategic Outpatient Behavioral Health De Novo Growth
Lifestance Health Group, based in Scottsdale, Arizona, operates one of the largest outpatient behavioral health networks with 534 locations by the end of 2021. Despite conducting approximately 80% of visits via telehealth, the company continues to open new clinics, planning 80 to 90 de novo centers in 2022.
CEO Michael Lester explained that the company’s hybrid model provides flexibility to adjust the pace of clinic openings based on patient and clinician demand for in-person care. Lifestance prioritizes growing its clinician workforce, which Lester describes as the primary driver of revenue, and has benefited from reimbursement parity with payers that support telehealth visits financially equal to in-person care.
This strategy reflects a measured approach to outpatient behavioral health de novo growth—recognizing telehealth’s advantages while ensuring in-person access for services that require physical presence or benefit from face-to-face interaction.
Mindpath Health: Expanding Clinic Density to Support Hybrid Care
Sacramento-based Mindpath Health operates over 100 locations across several states and employs about 700 clinicians. Even with telehealth utilization regularly exceeding 80%, Mindpath actively pursues outpatient behavioral health de novo growth to increase clinic density in key markets.
Chief Commercial Officer Julie McCarter describes their clinics as flexible hubs, allowing clinicians to toggle seamlessly between telehealth and in-person visits. This flexibility enables Mindpath to expand its clinician capacity and patient reach effectively without needing to open clinics in every new market immediately.
Mindpath’s ongoing outpatient behavioral health de novo growth complements its telehealth capabilities, offering patients multiple options to access care that fit their preferences and clinical needs.
Ideal Option: The Vital Role of Clinics in Addiction Treatment
Ideal Option PLLC, headquartered in Kennewick, Washington, operates 74 clinics in 10 states specializing in SUD treatment. Telehealth represents about 10% of their daily visits, used primarily to supplement in-person care rather than replace it.
CEO Tim Kilgallon highlights that many critical addiction treatment services, such as drug testing and medication-assisted treatment, must be conducted in person. Furthermore, he notes that the sense of community, accountability, and structure fostered by physical clinics plays a vital role in early recovery stages.
Ideal Option’s experience suggests that overreliance on telehealth can increase relapse risks. As a result, the company plans to open 12 additional clinics and expand into new states in 2022, driven by ongoing demand for in-person care.
Spero Health: Embracing Hybrid Care with Continued Clinic Expansion
Based in Brentwood, Tennessee, Spero Health saw telehealth visits spike to 90% at the onset of the pandemic but now reports around 25% of visits are virtual. Despite this decline, the company remains committed to outpatient behavioral health de novo growth, opening 24 new clinics in 2021 and planning a similar expansion in 2022.
CEO Steven Priest explains that addiction treatment requires more than prescriptions and virtual check-ins—it demands personal connection. He emphasizes that addiction is a disease of disconnection, and in-person engagement is crucial to patient success.
Spero’s growth strategy reflects a firm belief that hybrid models—leveraging telehealth as a tool but maintaining a physical presence—best serve the needs of their patient population over the long term.
Groups Recover Together: Telehealth and Clinics Working Hand in Hand
Groups Recover Together, located in Waltham, Massachusetts, fully embraced telehealth during the pandemic but also opened over 50 clinics since then. Chief Revenue Officer Cooper Zelnick says clinics remain essential for community-building and provide a safeguard against regulatory changes that could restrict telehealth.
While the company has validated strong patient outcomes through virtual care, it recognizes that physical spaces offer members informal opportunities for support and connection. This approach highlights the complementary nature of telehealth and outpatient behavioral health de novo growth.
Why Outpatient Behavioral Health De Novo Growth Remains Essential
Several factors explain why outpatient behavioral health de novo growth continues despite telehealth’s rise:
- Many treatments, including transcranial magnetic stimulation and drug testing, require in-person visits.
- Patients in early or intensive stages of recovery benefit from the structure, support, and accountability that clinics provide.
- Hybrid care models demand flexible physical spaces to accommodate shifting patient and clinician preferences.
- Clinics serve as community anchors that foster trust, engagement, and holistic recovery.
- Regulatory and reimbursement landscapes remain uncertain, making diversified delivery models prudent for long-term sustainability.
The Future of Behavioral Health Is Hybrid, Flexible, and Local
The behavioral health sector’s evolving landscape is characterized by a blended model that integrates telehealth and outpatient behavioral health de novo growth. This hybrid approach ensures greater access, optimizes clinical outcomes, and meets diverse patient needs effectively.
Providers investing in outpatient behavioral health de novo growth are positioning themselves for success in an increasingly complex and dynamic market. Physical clinics remain vital components of comprehensive care ecosystems, supporting telehealth’s advantages while addressing its limitations.
Ultimately, outpatient behavioral health growth is not a relic of the past but a forward-looking strategy that acknowledges the enduring value of face-to-face care alongside virtual innovation. The future of behavioral health is both digital and deeply human, with new clinics and telehealth working in concert to serve patients better than ever before.
