In the United States, the healthcare system faces a significant challenge: Too many people are not receiving the healthcare they need, and the situation is particularly dire when it comes to behavioral health. One in five adults suffers from mental health conditions, yet a large number of these individuals never receive the necessary care. The result is a worsening crisis that affects not only the mental health of patients but also their physical well-being. Erik Osland, CEO of evolvedMD, is among those leading the charge for change, advocating for a new approach that centers on the integration of mental and physical health care through Collaborative Care.
The Broken System: Gaps in Care and Communication
The current healthcare system, particularly in the realm of behavioral health, is broken. The lack of integration between mental health and physical health care creates gaps in communication and coordination, leading to inadequate care for patients who need it most.
“There’s a growing consensus around the fact that the system is broken,” says Erik Osland. “It’s not meeting the needs of the patients it’s designed to serve, and even more frustrating, it’s not really addressing the needs of the clinicians that work within it.”
Despite the well-established connection between physical and mental health, the system operates as though these two aspects of health are separate. This disconnect often results in fragmented care, where a person’s mental health needs are treated separately from their physical health needs. This lack of integration can cause patients to fall through the cracks, exacerbating both their mental and physical health issues and ultimately raising healthcare costs.
Osland points out that a staggering 50 to 70 percent of patients who could benefit from behavioral health services never receive them. The consequences are severe: untreated mental health conditions worsen physical health problems, creating a vicious cycle of poor health outcomes and higher healthcare expenses.
“The net result is that the vast majority of patients who need or could gain value from behavioral health services never receive them,” Osland explains. “Those patients get sicker, both from a mental and a physical health perspective. That impacts our communities and our providers, and ultimately leads to significant increases in healthcare costs.”
This is where Osland and his team at evolvedMD see the need for change. Instead of continuing to operate in a fragmented, disconnected system, Osland advocates for a more integrated approach—one that connects physical health care with behavioral health care through Collaborative Care.
Collaborative Care: A Vision for the Future of Behavioral Health
At the heart of Osland’s advocacy is the concept of Collaborative Care. Collaborative care refers to an integrated approach where primary care and behavioral health services are combined into a seamless, coordinated system of care. The idea is simple: a person’s physical and mental health needs should be addressed together, not separately. In Osland’s words, “Collaborative care is a centerpiece to the future of the healthcare system.”
But what does Collaborative Care actually look like in practice?
Osland outlines three critical components of a new system:
- Integration: Physical health care and mental health care should not be siloed. They must be interconnected to address the whole person. A person with diabetes and depression, for example, will not receive effective care if their physical health is treated separately from their mental health.
- Comprehensiveness: The new system must be comprehensive, ensuring that patients receive all-encompassing care that addresses their mental, physical, and emotional needs.
- Collaboration: Perhaps the most important aspect, collaboration is key to ensuring that all care providers—primary care physicians, mental health specialists, insurers, and support staff—work together toward the same goal: the patient’s well-being.
By working collaboratively, healthcare providers can offer more effective and personalized care that improves both mental and physical health outcomes for patients.
The Challenges of Behavioral Health Care Today
Despite the obvious need for a more integrated system, there are several obstacles that stand in the way of change. One of the primary challenges is the lack of resources and training for primary care physicians to effectively treat mental health conditions. Many primary care providers are not adequately trained in behavioral health, yet they are often the first point of contact for patients dealing with mental health issues.
“There’s a lack of resources, funding, and training for primary care physicians to treat mental health conditions effectively,” Osland notes. “In many cases, clinicians are not equipped with the skills or tools to manage mental health conditions, and as a result, they aren’t able to provide adequate care.”
This leads to troubling statistics. In 2022, more than 60 million adults in the U.S. reported a mental health issue, yet nearly half of them did not receive treatment. Of those who did receive treatment, many did not see a mental health specialist but were instead treated by their primary care provider—highlighting the lack of access to specialized care.
The gaps in care also result in higher healthcare costs. Patients with both physical and mental health conditions often incur three to six times higher healthcare costs than those with physical health conditions alone. As Osland explains, the system is not designed to deliver highly coordinated care, and the incentives for healthcare providers are not aligned to promote the integration of mental and physical health services.
“We’ve built a system of behavioral health that is largely underfunded,” Osland says. “The incentives aren’t aligned to deliver coordinated care. In many cases, clinicians are overwhelmed, burned out, and not supported in their professional development. They lack the resources to manage their patients effectively, and as a result, patients suffer.”
New Research Shows the Benefits of Collaborative Care
There is growing evidence supporting the effectiveness of Collaborative Care in improving behavioral health outcomes. A May 2024 research paper from the Bowman Family Foundation examined the impact of the Collaborative Care Model (CoCM) on behavioral health. The study, which spans research from 2007 to 2024, found that CoCM led to lower healthcare costs and better mental health outcomes for patients.
Some key findings from the research include:
- CoCM patients had 114 more depression-free days compared to those receiving traditional care.
- CoCM patients had lower mean outpatient healthcare costs by $594 per patient compared to those receiving usual care.
- Over four years, CoCM patients had $3,363 lower total healthcare costs compared to those receiving traditional treatment.
- A 2015 study found that in the 12 months following the initiation of CoCM, there was a 13% per member per month total healthcare cost savings for CoCM patients compared to those receiving standard treatment.
These findings support the idea that integrating behavioral health services into primary care not only improves mental health outcomes but also reduces overall healthcare costs. For Osland and evolvedMD, this research underscores the importance of tying behavioral health to primary care settings through Collaborative Care.
“By bringing behavioral health care into primary care, we are creating a more efficient, patient-centered system that benefits everyone,” Osland says. “We need a system that connects people to the care they need, when they need it. Collaborative Care ensures that patients are treated holistically, with their mental and physical health addressed simultaneously.”
The Vision for a Healthier, More Integrated Future
Osland’s vision for the future of healthcare is one where behavioral health is seamlessly integrated into the broader healthcare system. He emphasizes the importance of viewing behavioral health as an essential part of overall health care, not a separate or secondary service.
“We need more patients to be able to access care,” Osland says. “Integrated care, and Collaborative Care specifically, is the future of behavioral health. Let’s create a system where patients are supported from all angles, where they can get the help they need and go on to live healthy, productive lives.”
Osland is not interested in merely tweaking the current system. He is advocating for something truly innovative and disruptive—a complete overhaul of the way behavioral health is delivered. “Let’s not just accept the status quo,” he urges. “Let’s see true change. There’s no point in pursuing anything less than that.”
Conclusion: The Path Forward
The need for a new approach to behavioral health is clear. With millions of people suffering from both physical and mental health conditions, it is essential that the healthcare system evolve to provide integrated, comprehensive, and collaborative care. The current fragmented model is failing both patients and providers, contributing to rising healthcare costs and poor patient outcomes.
By embracing Collaborative Care, we can create a healthcare system that addresses the whole person—body and mind. This integrated model offers the promise of better outcomes, lower costs, and a more supportive environment for both patients and providers. As Erik Osland and evolvedMD continue to push for change, their goal is simple: to build a healthcare system that truly serves the needs of every patient, providing the care they deserve in a coordinated and efficient way.
The future of behavioral health care is collaborative. It’s time to disrupt the status quo and create a system that treats the whole person, not just parts of them. Let’s make this vision a reality.
