Behavioral health care is facing a critical turning point, as health care stakeholders intensify their focus on behavioral health access and outcomes. With rising demand and persistent provider shortages, the immediate priority remains improving access to care. However, the industry is also laying the groundwork to measure and enhance outcomes—shifting the spotlight from simply providing care to ensuring that care truly benefits patients.
Addressing the Challenge of Behavioral Health Access
The shortage of behavioral health providers has created substantial barriers to timely and effective care. Access to behavioral health services is often complicated by limited provider availability and patients’ difficulty navigating insurance and treatment options. These challenges are even more acute for Medicare and Medicaid patients, for whom behavioral health access are especially hard to secure.
Samir Malik, CEO of firsthand, a startup dedicated to connecting patients with serious mental illnesses to community resources, noted the slow progress in expanding the provider pool. “We haven’t really addressed supply constraints in meaningful ways,” Malik said. He emphasized that improving behavioral health access and outcomes will require both adding providers and helping existing ones practice more efficiently.
CMS data reveals that nearly 43% of providers refusing Medicare reimbursement specialize in behavioral health, highlighting a key barrier to behavioral health access for a vulnerable patient population.
Payers’ Focus on Access as a Foundation for Better Outcomes
Payers such as Humana Inc. see behavioral health access and outcomes as intertwined challenges. Dr. Taft Parsons, Humana’s enterprise medical director of behavioral health, explained that access remains the biggest hurdle. “There simply aren’t enough insurance-participating providers to meet our members’ needs,” he said. Parsons also noted that many patients receive medication management from primary care providers, which may not optimize behavioral health outcomes.
Effective behavioral health access and outcomes require connecting patients to specialized providers who can offer tailored treatment plans.
Navigating to the Right Care
Beyond provider shortages, navigation issues complicate efforts to improve behavioral health access. Patients often struggle to find the right type of care that accepts their insurance. Sandra Kuhn, head of commercial enablement at Headspace Health, stressed the importance of guiding patients to appropriate services. Headspace Health’s blend of apps, virtual coaching, therapy, and psychiatry exemplifies innovative approaches to improving behavioral health access.
Outcomes: The Future of Behavioral Health
While access dominates current efforts, industry leaders stress the importance of evolving toward outcome measurement. Malik pointed out that as access barriers fall, the sector must focus on building scalable models to track and improve behavioral health access and outcomes through data-driven approaches.
Dr. Parsons agrees that quality measurement is in its early stages but vital for true progress. He noted that most organizations still focus on process metrics rather than patient-centered outcomes, which are essential to advancing behavioral health access and enabling value-based care.
The Role of Outcomes in Value-Based Care
Measuring outcomes is central to value-based care, which aligns payment with quality rather than quantity. For payers and providers alike, emphasizing behavioral health accesswill drive improved care delivery, better patient health, and more sustainable health systems.
Conclusion
The behavioral health sector’s immediate challenge is improving access, but the longer-term focus must shift to outcomes. By addressing behavioral health access, stakeholders—including startups, payers, and providers—can build a care system that not only reaches more patients but truly improves their lives.
This dual focus on access and outcomes will shape the future of behavioral health care, ensuring that as the system expands, it becomes more effective, efficient, and patient-centered.
