As 2023 unfolded at a dizzying pace, several significant developments in the behavioral health space may have escaped notice. While many headlines focused on immediate crises and challenges, certain key developments quietly reshaped the industry. These overlooked stories represent meaningful shifts in critical industry narratives, serving as hidden gems and emblems of the year’s progress. Now, with the benefit of hindsight, we can truly appreciate these events and explore what they might indicate for the future of behavioral health. Below, we revisit some of the most impactful Behavioral Health Developments in 2023 that may have flown under the radar but are poised to shape the industry’s future.
LifeStance Health’s Strategic Shift
One of the biggest Behavioral Health Developments in 2023 came from LifeStance Health, which made a notable change in its growth strategy. Known for its aggressive mergers and acquisitions (M&A) approach, LifeStance Health began scaling back in a big way. After spending years rapidly expanding by acquiring multiple practices, the company made the decision to focus on profitability rather than growth. This shift signaled a new era in behavioral health, one that demands greater sophistication and maturity.
LifeStance Health’s decision to stop acquiring practices and instead focus on opening new centers reflects the changing landscape of the industry. The company had previously relied on private equity-backed M&A, completing 90 acquisitions by the end of 2022. However, its pivot toward establishing de novo centers represents a more sustainable growth model moving forward. This decision to focus on quality over quantity and streamline operations is one of the most underappreciated Behavioral Health Developments in 2023.
The Slowdown in M&A Activity
2023 also saw a significant dip in deal volumes within the behavioral health sector. While M&A activity had been booming in previous years, it hit a low in 2023, with only 116 deals tracked by The Braff Group by the third quarter. This contrasts sharply with 2021, which saw a record-setting 251 deals. Many of the transactions in 2023 were underreported or didn’t make the splash that deals in previous years had.
Some noteworthy but quietly impactful Behavioral Health Developments in 2023 include the acquisition of Embark Behavioral Health by Consonance Capital Partners and BlueSprig Pediatrics’ acquisition of Trumpet Behavioral Health. Despite their significance, these deals didn’t garner as much attention as they might have in previous years. This shift may suggest that the industry is maturing, and the focus is increasingly on long-term sustainability rather than short-term growth.
Methadone Clinic Deregulation: A Bipartisan Push
One of the more contentious Behavioral Health Developments in 2023 centered around the push to deregulate methadone access. As the opioid overdose crisis deepened, exacerbated by the rise of fentanyl and other illicit substances, lawmakers began focusing on loosening regulations surrounding methadone clinics. The Modernizing Opioid Treatment Access Act was introduced in March, aiming to make it easier for individuals to access methadone as part of their opioid use disorder (OUD) treatment.
This move reflects the growing bipartisan support for tackling the opioid crisis and expanding access to treatment. While some organizations, such as the American Association for the Treatment of Opioid Dependence (AATOD), have voiced opposition, the bill passed through the U.S. Senate Health, Education, Labor and Pensions (HELP) Committee in December. This is a crucial step toward expanding treatment options for people suffering from OUD, making it one of the most significant Behavioral Health Developments in 2023.
The Growing Influence of Value-Based Care
2023 also highlighted a shift toward value-based care within the behavioral health sector. Despite some skepticism, there was a notable push toward incorporating outcome data into behavioral health treatment plans. However, this transition was not without challenges. A survey by Alma found that 77% of therapists expressed concern that insurance companies might use outcome data to deny care. This resistance points to the complexities of implementing value-based care effectively in a field that relies heavily on subjective assessments.
The push for outcome-based care is central to many Behavioral Health Developments in 2023, as it reflects a broader trend toward improving treatment efficacy and accountability. However, there remains significant uncertainty about how this data will be utilized and how it will affect reimbursement processes. While this development has the potential to transform the industry, its full impact is still unfolding.
UnitedHealth Group’s Continued Expansion into Behavioral Health
UnitedHealth Group’s quiet but strategic moves in 2023 also represent an important Behavioral Health Development in 2023. The company continued to integrate mental health services into its broader health care offerings through its subsidiary, Optum. UnitedHealth’s acquisition of Refresh Mental Health and the subsequent expansion into outpatient services demonstrate its ongoing commitment to consolidating behavioral health into its health care model.
UnitedHealth also introduced free virtual behavioral health coaching for 5 million members, signaling its growing role in expanding access to mental health care. While the company’s actions haven’t generated massive headlines, its influence in the behavioral health space is undeniable. UnitedHealth’s role as a “silver-backed gorilla” in the healthcare sector makes these developments especially significant.
The Challenge of Payer Ghosting
Another critical Behavioral Health Development in 2023 was the issue of “payer ghosting,” a practice where insurance companies fail to communicate or respond to providers seeking to collect claims. This problem has plagued the behavioral health industry for years, yet it has not received the level of attention it deserves. Payer ghosting results in a frustrating lack of resolution for providers, making it increasingly difficult to navigate the reimbursement process.
As the behavioral health space continues to grow, this issue will need to be addressed more effectively. Providers are looking for solutions to improve transparency and communication with payers, but until that happens, payer ghosting remains one of the industry’s most persistent problems.
Conclusion: A Year of Quiet Growth and Change
While 2023 may have been overshadowed by more prominent crises, these Behavioral Health Developments in 2023 mark pivotal shifts in how the industry is evolving. From LifeStance Health’s strategic reorientation to the legislative push for expanded methadone access, the year was full of quiet but meaningful progress. As we move forward, these developments will serve as the foundation for a more sophisticated and mature behavioral health landscape, signaling the changes that are likely to continue shaping the industry in the years to come.
