For years, the conversation around value-based care in behavioral health has centered on one persistent issue: access. Health plans and providers alike have poured time, effort, and funding into ensuring people can get in the door. But as the dust begins to settle around access, a more complex and critical challenge is emerging — measuring outcomes in behavioral health.
At the recent Behavioral Health Business VALUE conference, industry leaders echoed a shared truth: access is foundational, but it’s not the finish line. Dr. Nick Dewan, Vice President of Behavioral Health at GuideWell and Florida Blue, captured this sentiment:
“By bringing access [to members], you bring value… I think once we do that, then we can go on to measuring results… cost and outcomes.”
GuideWell, the parent company of Florida Blue, covers over 5.9 million Floridians and brings in $30 billion annually. With such scale, their focus on access makes sense. They’ve tackled the issue by partnering with Lucet, a digital behavioral health company. The goal? Help members find in-network providers quickly and schedule appointments without delay.
Yet while digital partnerships are solving one problem, they risk sidelining another: measuring outcomes in behavioral health. This is where real value lives — not just in seeing more patients, but in proving that the care they receive works.
Access Isn’t Value — It’s the Beginning
Across the behavioral health landscape, payers are willing to pay more simply for quicker access. That’s the current baseline, and it’s setting the bar low.
“We’re at the point where we’re paying extra just for access,” said Dr. Taft Parsons III, Vice President and Chief Psychiatric Officer at CVS Health. “I don’t think that we’ll ever get to the point where we can say this person isn’t using evidence-based practice. Therefore, we don’t need them in the network. I don’t see that in the near or foreseeable future.”
The challenge is clear: payers want access, but they’re not yet willing to limit networks based on clinical quality. This hesitancy may slow down the momentum around measuring outcomes in behavioral health, even as the need for it grows more urgent.
Providers Agree: Access Is a Means, Not the End
It’s not just payers pushing for access. Providers recognize it as the first domino in a much larger chain. “Access is a value to providers; access is a value to patients. Access is not an outcome,” said Dr. Navdeep Kang, Chief Quality Officer of Inpatient Services at Acadia Healthcare. “It’s a process measure or a proxy for an eventual good outcome.”
Acadia Healthcare, which operates more than 253 facilities across 39 states, sees the bigger picture. Providers can’t wait forever to focus on quality. The system must evolve to balance both priorities. And that evolution starts with better frameworks for measuring outcomes in behavioral health.
But that’s easier said than done. Outcomes differ by setting. Inpatient facilities need to track measures like seclusion and restraint rates. Outpatient providers may focus more on symptom reduction and patient functionality. A one-size-fits-all solution simply won’t work.
The Complexity of Measuring What Matters
“We don’t have a great way to measure what good care really is,” Parsons said. And that’s the crux of the issue. There’s no universally accepted metric — yet. But we need them. Because ultimately, measuring outcomes in behavioral health is what will drive more meaningful contracting, payment models, and patient success.
Value-based care can’t survive on vague assumptions. Without clear outcomes, payers can’t confidently determine what care is truly worth paying for. Nor can providers demonstrate their effectiveness or receive incentives that reward excellence.
Parsons explains that defining value must begin with identifying the patient population and the care setting. From there, stakeholders can determine what outcomes matter most to everyone involved — not just the payer or the provider, but most importantly, the patient.
Reframing Value to Include the Patient Voice
“When we think about value as clinicians, we also think about the patient and what’s valuable to them– the experience of care, functional improvements in terms of quality of life,” Kang said. These elements are critical yet often left out of the core metrics. Measuring outcomes in behavioral health must include clinical benchmarks, cost-efficiency, and patient-reported experiences.
Ignoring the patient perspective leads to narrow definitions of success. For example, lowering readmission rates might look great on paper but fail to capture whether the patient’s quality of life actually improved. The system must adopt a broader, more human-centered lens.
Building the Right Metrics (Without Reinventing the Wheel Every Time)
With so much variability across patient types, diagnoses, and settings, there’s a growing risk of fragmentation. Payers and providers often develop one-off value frameworks for each contract — a time-consuming and inefficient process.
“I think the macro difficulty is finding alignment,” Kang said. “What are we using to define quality? How are we measuring it? And then, ultimately, what are we looking for in the longer term? And how are we marshaling all of that data?”
To succeed in measuring outcomes in behavioral health, stakeholders need consistency without rigidity. A shared foundation of metrics — customizable to patient needs — could strike the right balance.
Looking Ahead: Access + Outcomes = Real Value
The current state of behavioral health contracting is heavily weighted toward access, and that’s a necessary phase. But we can’t stay here. True value lies in showing that the care patients receive changes their lives.
That means shifting the conversation — and the infrastructure — toward measuring outcomes in behavioral health. It means building flexible, evidence-based systems that reflect both clinical quality and patient experience. And it means making this work repeatable and scalable across the system.
Access may open the door. But outcomes are what justify walking through it.
Final Thoughts
The behavioral health industry stands at a tipping point. The supply-demand imbalance has forced payers to prioritize getting people care, fast. But the long-term health of the system will depend on what happens after that care begins.
For providers, payers, and patients alike, the real promise of value-based care lies not in numbers served, but in lives changed. And that begins with a renewed commitment to measuring outcomes in behavioral health.
