The U.S. healthcare system has long been criticized for its failure to adequately address the mental health needs of racial and ethnic minority groups. Behavioral Health Care for Underserved Populations highlights stark disparities, with research showing these groups are 20% to 50% less likely to initiate mental health services and 40% to 80% more likely to drop out of treatment prematurely compared to their white counterparts. These gaps reflect deep-rooted challenges in healthcare access, cultural sensitivity, and the broader social determinants of health that affect marginalized communities.
In an effort to address these issues, behavioral health providers are increasingly focusing on specialized services tailored to people of color, marginalized individuals, and Medicare and Medicaid beneficiaries. By rethinking traditional care models and prioritizing inclusivity, these providers aim to ensure that all individuals, regardless of their background, receive the mental health care they need. A recent discussion at Behavioral Health Business’s VALUE conference highlighted the critical role of data collection in bridging the gap in care for underserved populations, emphasizing the importance of collecting detailed patient data to better understand and meet the needs of these communities.
The Role of Data Collection in Serving Underserved Populations
At the heart of addressing disparities in Behavioral Health Care for Underserved Populations is the ability to gather comprehensive, accurate, and relevant data. Providers serving these communities must go beyond traditional health assessments to gain a holistic understanding of their patients’ needs. This means not only tracking the patient’s immediate health concerns but also considering a variety of external factors, such as access to transportation, food insecurity, and housing status, which can significantly impact a person’s mental health.
Evans Rochaste, the founder and CEO of ReKlame Health, a New York City-based virtual-first provider offering psychiatric care, addiction treatment, and care coordination for BIPOC communities, underscored the importance of robust data collection. His company, which serves individuals from diverse racial and ethnic backgrounds, relies heavily on data to engage patients effectively and demonstrate the value of its services.
“We know that payers and investors want to see evidence of engagement and outcomes in populations that have faced historical challenges in engaging with healthcare,” Rochaste said. “It’s critical to track data early on to demonstrate value.”
ReKlame’s model is grounded in diversity, with approximately 55% of its patient base identifying as BIPOC, and 90% of its care team members sharing this identity. By maintaining a diverse clinical staff, ReKlame aims to foster trust and create an environment where patients feel understood and supported. This approach aligns with a growing trend in the healthcare industry: the recognition that inclusive care is not only morally imperative but also leads to better outcomes for underserved populations.
Specialized Care Models for Marginalized Populations
Providers who focus on specialized care for underserved populations often operate with a deep understanding that these individuals may face unique challenges that require tailored solutions. For instance, Arise, a virtual provider offering eating disorder treatment, is specifically designed to address the needs of those who have historically been underserved in this space, including individuals from marginalized groups.
Arise’s approach involves a multidisciplinary care team, consisting of a therapist, dietitian, and care advocate with lived experience of eating disorders. This model, which includes both individual therapy and online group support, is particularly relevant for individuals who may not feel comfortable seeking help in traditional, in-person settings.
Chief Medical Officer Erikka Taylor explained that traditional mental health assessments like the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) are commonly used across the industry but may not always capture the specific needs of underserved populations. While these assessments are valuable, they often overlook critical factors such as cultural context or socio-economic stressors that disproportionately affect marginalized communities.
To address this, Arise takes a more comprehensive approach to data collection. In addition to standard mental health assessments, the company also measures social determinants of health, such as food insecurity, transportation access, and housing stability. By tracking these factors, Arise can provide more holistic care that accounts for the complexities in its patients’ lives.
“Failing to track social determinants of health is like treating patients in a vacuum,” Taylor said. “We know that a person’s mental health is closely tied to their lived experiences, so understanding those factors is crucial to offering effective care.”
Transitioning to Value-Based Care Models
As more providers focus on specialized care, there is also a shift toward value-based care models. Unlike the traditional fee-for-service model, which compensates providers based on the number of services delivered, value-based care focuses on patient outcomes and the overall value provided to patients. This shift is particularly important for providers working with underserved populations, as it encourages providers to invest in long-term solutions that improve patient outcomes rather than relying on short-term interventions.
However, the transition to value-based care models requires careful planning and data collection. Providers must track a wide range of performance indicators, including engagement rates, treatment adherence, and patient satisfaction, to demonstrate the effectiveness of their services.
For ReKlame, tracking key performance indicators (KPIs) from the very beginning was crucial, even when the company initially operated under a fee-for-service model. Rochaste advises other providers looking to implement value-based care to start by identifying metrics that align with both patient needs and the expectations of insurers and investors.
“Start tracking those KPIs right away,” Rochaste urged. “Even if you’re in a fee-for-service model, track the metrics that matter most for your patients and your stakeholders. The goal is to show value, and that starts with data.”
While the process of collecting comprehensive data and aligning care models with value-based frameworks can be resource-intensive, it ultimately helps providers demonstrate the cost-effectiveness of their services. For example, tracking outcomes such as reduced emergency room visits and hospital admissions can show how proactive behavioral health care prevents more costly interventions.
Navigating Challenges in Reimbursement and Outcome Measures
Another challenge that specialized behavioral health providers face is navigating the complexities of reimbursement. Different aspects of care, especially when dealing with conditions like eating disorders, may cross the boundaries of both medical and psychiatric care, which can complicate negotiations with payers.
Taylor explained that eating disorders, for example, often require a combination of psychiatric and medical care, which means that reimbursement models must be flexible enough to account for both aspects. Unfortunately, many existing outcome measures used for reimbursement, such as the PHQ-9, may not capture all the necessary data to demonstrate the success of treatment for complex conditions like eating disorders.
“It’s hard to have integration and collaboration with payers when the outcome measures used for mental health don’t always align with the medical outcomes needed for eating disorders,” Taylor said. “There’s a lack of integration between the different arms of care, and that can make it difficult to achieve reimbursement for the full spectrum of services our patients need.”
To overcome these challenges, providers must work closely with payers to ensure that outcome measures are aligned with treatment goals. This means engaging in ongoing discussions about what constitutes “success” in treating mental health conditions, particularly when those conditions have both medical and psychiatric components.
The Growing Investment in Specialized Behavioral Health Care
The demand for culturally competent care has also led to significant investments in behavioral health providers that cater to specific populations. For example, Folx, a tech-enabled care provider offering virtual talk therapy and medication management for LGBTQIA+ populations, raised $30 million in Series B funding in 2022. This funding enabled Folx to expand its offerings to include mental health services, further demonstrating the growing demand for specialized care models.
Similarly, Anise Health, a digital mental health platform focused on Asian American communities, raised $1.2 million in pre-seed funding in 2023. The company recently expanded its services to six states, indicating the potential for such specialized platforms to grow and meet the unique mental health needs of underserved populations.
Conclusion
Improving access to mental health care for underserved populations is essential for reducing disparities in health outcomes across the U.S. By tailoring services to the unique needs of marginalized groups and collecting comprehensive data to track outcomes, behavioral health providers can not only enhance patient engagement and satisfaction but also improve the overall quality of care.
The transition to value-based care models and the integration of social determinants of health into treatment plans are vital steps toward achieving more equitable mental health care. As the industry moves forward, behavioral health providers that prioritize inclusivity, data-driven decision-making, and the needs of specialized populations are better positioned to drive change and secure the investment necessary to expand their services.
By addressing the mental health needs of racial and ethnic minorities, marginalized individuals, and Medicare/Medicaid beneficiaries, these providers are not only improving care for their patients but also creating a more inclusive and equitable healthcare system for all. In doing so, they are setting a new standard for behavioral health care for underserved populations, where inclusivity, data, and patient-centered care come together to create lasting change.
As the demand for specialized behavioral health care for underserved populations grows, so too will the opportunities for innovation, funding, and ultimately, better care for those who need it most. By aligning care models with the unique needs of these communities, providers can ensure that everyone, regardless of background or circumstance, has access to the high-quality behavioral health care for underserved populations they deserve.
With comprehensive data collection, strong partnerships with payers, and a focus on cultural competence, the future of behavioral health care for underserved populations looks promising—and will ultimately help bridge the gap that has existed for far too long in the mental health field.
