The landscape of behavioral health outpatient services is undergoing a significant transformation as the industry embraces value-based care models. Historically, behavioral health benefits have often been carved out from physical health coverage, creating fragmented care silos that limited coordination and hindered comprehensive treatment. Today, a growing consensus among health care leaders signals the end of these carve-outs, as integrated care approaches take center stage to improve patient outcomes and reduce overall costs.
Dr. Katherine Knutson, CEO of Optum Behavioral Care and senior vice president at UnitedHealth Group, emphasized this shift during the Behavioral Health Business event VALUE, stating plainly, “We can eliminate the carve-outs.” UnitedHealth is actively working to implement models that take a total cost of care approach—one that reflects the reality that behavioral health, physical health, and social determinants are deeply interconnected in patient care.
Understanding the Need for Integration in Behavioral Health Outpatient Services
The need for integrated behavioral health outpatient services is underscored by the complex profiles of many patients. According to data referenced by Moody’s Investor Service, individuals with behavioral health conditions generate 3.5 times more health care costs than those without, yet only about 7.9% of these costs are directly related to behavioral health care itself. This disconnect illustrates why treating behavioral and physical health separately can result in missed opportunities for better outcomes and cost savings.
Integrated behavioral health outpatient services mean that patients receive more coordinated care that addresses the full range of their health needs in one system. This approach improves communication between providers, reduces duplicative services, and supports more effective management of chronic conditions, including mental health and substance use disorders.
Expanding Access through Outpatient Services and Retail Clinics
Optum and UnitedHealth Group have made outpatient care a cornerstone of their behavioral health strategy, focusing on delivering services that are both clinically effective and cost-efficient. Dr. Knutson highlighted the importance of outpatient settings for treating a wide spectrum of behavioral health issues—from mild to moderate conditions to more complex and severe illnesses.
The rise of retail health clinics, such as CVS Health’s MinuteClinics and HealthHUBs, further expands access to behavioral health outpatient services. With most Americans living within 10 miles of a CVS location, these clinics provide convenient access points for mental health care, including therapy and counseling services delivered either in person or through telehealth. CVS Health has already conducted millions of virtual behavioral health visits, signaling the scalability of this model.
Cara McNulty, president of behavioral health and employee assistance program at Aetna (a CVS Health company), emphasized that while CVS does not plan to offer advanced psychiatric services onsite, partnerships with local health systems help ensure patients receive the appropriate level of care.
Innovative Care Models Driving Behavioral Health Outpatient Services
Value-based care models are reshaping how behavioral health outpatient services are delivered and reimbursed. Eleanor Health, founded in 2019 by Corbin Petro, exemplifies this by offering serious mental illness and substance use treatment through value-based and population health-driven frameworks. Eleanor Health derives the vast majority of its revenue from value-based contracts, reflecting a commitment to outcomes over volume.
The partnership ecosystem between payers like Aetna and UnitedHealth and providers such as Eleanor Health enables more coordinated behavioral health outpatient services. These collaborations leverage data to identify patients’ needs and deliver tailored, evidence-based care. The result is improved patient engagement, better health outcomes, and more sustainable financial models.
Overcoming Challenges in Implementing Value-Based Behavioral Health Outpatient Services
Despite the promise of value-based care, significant challenges remain in fully integrating behavioral health outpatient services. One of the most pressing issues is the lack of standardized outcome measures that adequately capture clinical effectiveness, patient experience, and cost impact. Without consistent metrics, it is difficult for providers and payers to evaluate the success of value-based contracts and ensure accountability.
Additionally, many behavioral health providers face technological and operational barriers to participating in value-based models. The fragmented nature of behavioral health services has historically led to data silos and limited information sharing, complicating efforts to track outcomes and coordinate care across settings.
Nonetheless, investments in technology, data analytics, and collaborative care models are beginning to address these barriers. Organizations are increasingly adopting interoperable systems and evidence-based practices that facilitate outcome measurement and continuous quality improvement in behavioral health outpatient services.
The Broader Impact of Value-Based Care on Behavioral Health
The shift to value-based care in behavioral health outpatient services reflects a larger industry transformation toward whole-person care. Leaders such as Dr. Knutson, Petro, and McNulty emphasize that addressing patients’ mental health, physical health, and social needs in an integrated manner produces the best outcomes. As McNulty put it, “When we stop treating people’s head and heart as separate—and we focus on prevention, intervention, and high acuity care, using data and addressing social determinants—that’s when we get the best outcomes.”
Eliminating carve-outs is a critical step toward this vision. By aligning incentives around the total cost of care and integrating outpatient services within broader health systems, payers and providers can break down traditional silos and deliver care that truly meets patients’ needs.
Looking Ahead: The Future of Behavioral Health Outpatient Services
The behavioral health field stands at a pivotal moment. Expanding access through outpatient services, leveraging retail and virtual care platforms, and aligning payment models around value are reshaping the way care is delivered. UnitedHealth’s acquisition of Refresh Mental Health, with its extensive outpatient network, is one example of how major players are investing to build comprehensive, integrated behavioral health systems.
While challenges remain, the growing momentum behind value-based care in outpatient services promises a future where patients receive coordinated, high-quality care that improves outcomes and controls costs. The industry’s collective efforts signal that behavioral health will no longer be treated as an afterthought but as an essential component of holistic health care.
