The U.S. behavioral healthcare market is valued at US$ 90.5 billion in 2020 and is projected to grow to in excess of US$ 130 billion by 2027, poised to grow at a noteworthy CAGR of 5.3% during the forecast period 2021 to 2027, according to Precedence Research. There is no doubt that the penetration of digital technologies and increased funding to address behavioral health issues have propelled the growth in this market.
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With the recent investments, government grants, attention, and support now available to the industry, what changes do we expect to occur in the near term? What will be the top priorities for providers and payers? What can the industry do to meet the increased demand for behavioral health services, especially as we face such a dire shortage of clinicians?
The past couple of years has shed a bright light on behavioral health. The de-stigmatization of behavioral health has allowed patients to feel more comfortable about seeking care. Further, investment dollars have started to flow into this segment focused on expanding access. That said, we now find ourselves in a certain predicament; we now have more patients seeking care than we have clinicians to provide for them creating significant backlogs and further stressing the healthcare system.
Below, I share my top two predictions for the behavioral health industry for 2022. I’m optimistic that with these near-term shifts, we can make the improvements needed in the industry to bring efficient and effective care and treatment to all those in need.
The shift of focus from access to quality
The conversation will evolve from access to care to quality of care. The question will no longer just be: “is our front door open to all people who need help?” It will also be: “Are we delivering the right care to the right person at the right time for the right amount of time?” After all, what is the purpose of serving more people if we can’t effectively and efficiently improve patient outcomes through the delivery of quality care?
We will also see a focus on measuring quality in our ever-growing telehealth delivery model. Virtual visits skyrocketed during the pandemic, and experts agree that this approach will continue, especially in behavioral health. Industry leaders are now strategizing on how to sustain telehealth moving forward, and ensure the quality of telehealth delivery is as good in delivering patient outcomes as in-person visits.
In order to ensure high-quality care, behavioral health organizations will increasingly rely on measurable data to track patient and population outcomes. Data, derived from evidence-based assessments, intake forms, including social determinants of health insights, is ultimately what will inform clinical and operational executives if their programs and treatment plans are working. This information is also essential in determining how to make meaningful improvements to deliver the most effective and efficient care.
Delivering high-quality care starts and ends with data. In 2022, behavioral health providers will both gather and utilize data in new ways to help drive the quality of care.
Progress toward value-based care in behavioral health
Value-based care models center on patient outcomes rather than on services or visits. Unlike the traditional fee-for-service model, value-based models align payer and provider incentives towards well care rather than sick care. Under this model, the focus is on quality and outcomes performance rather than patient/member utilization of services.
Payers strive to build and nurture behavioral health provider networks that provide access and high-quality care to their members. Because behavioral health co-morbidities have been linked to higher medical costs, the urgency to improve the behavioral health of members is of the utmost importance.
Providers recognize that they can track patient progress and outcomes with objective measurement data to demonstrate to payers the improvement they are making with their patient populations. They are using this data as a critical asset in negotiating value-based contracts with their payers as well as provide greater transparency and alignment.
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We are already seeing some well-defined pilots with preferred provider networks being established. These pilots set clear, demonstrable and measurable objectives that incentivize providers to share outcomes data to increase transparency.
I predict that the year 2022 will bring in defined milestones and clear progress toward value-based care in behavioral health. There will be more pilots and programs of value-based reimbursement contracts between payers and providers. I predict there will be a dramatic increase in value-based contracts next year. The traditional fee-for-service model won’t disappear for years to come, but there will be thoughtful pilots of reimbursement programs that reward providers for quality of care and clinical outcomes.
As stated previously, I believe that two shifts will happen in order to overcome the current dilemma:
- Improve clinical outcomes for those that are suffering
- Expand access to care for those who need it
It’s really not a complex concept. We need to provide more people with access to care and implement the most efficient and effective treatments that lead to quicker patient recoveries towards their treatment targets. Achieving these two goals is key to addressing today’s behavioral health crisis, but neither of these shifts can occur without grounding our care in evidence-based data.
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