Why aren’t value-based care arrangements more common in behavioral health care?

Value-based care arrangements have become more common in healthcare as a way to improve patient outcomes while reducing healthcare costs. However, these arrangements haven’t been as widely adopted in behavioral health care as in other areas of healthcare. In this article, we’ll explore the reasons why value-based care arrangements are more uncommon in behavioral health and what can be done to change this.

Lack of Quality Measures:
One of the main reasons why value-based care arrangements are uncommon in behavioral health is the lack of quality measures. When it comes to measuring the value of behavioral health interventions, the traditional measures used in other areas of healthcare just don’t work. Mental health and substance use disorders are complex and often require long-term care. This can make it difficult to develop quality measures that truly reflect the impact of care on patient outcomes. Until quality measures are developed, it will be challenging to create value-based care arrangements that work in behavioral health care.

Difficulty in Predicting Costs:
Another challenge in implementing value-based care arrangements in behavioral health care is the difficulty in predicting costs. Mental health and substance use disorders can be unpredictable, leading to more than the expected number of visits, hospitalizations, or medications. This can create financial risk for providers and payers in value-based care arrangements. Until there is more data and experience in predicting costs, it will be difficult to create sustainable value-based care arrangements in behavioral health care.

Underinvestment in Behavioral Health:
Another contributing factor to the lack of value-based care arrangements in behavioral healthcare is the underinvestment in this area of healthcare. Behavioral health has long been underfunded, leading to a shortage of mental health and substance use disorder providers, inadequate reimbursement rates, and limited access to care. This lack of investment creates challenges for providers and payers in developing and implementing value-based care arrangements. Until there is adequate investment in behavioral health care, it will be challenging to create value-based care arrangements that improve patient outcomes while reducing healthcare costs.

Regulatory Barriers:
Regulatory barriers are also a significant issue when it comes to value-based care arrangements in behavioral health care. The current regulatory environment can make it challenging for providers and payers to experiment with new models of care, including value-based care arrangements. For example, current anti-kickback statutes can prevent providers and payers from collaborating effectively, hindering efforts to create aligned, value-based care arrangements. Until there are changes in the regulatory environment, it will be challenging to create value-based care arrangements that work in behavioral health care.

Lack of Collaboration:
Finally, the lack of collaboration between payers and providers is another factor that can hinder the adoption of value-based care arrangements in behavioral health care. In many cases, payers and providers operate in silos, making it difficult to develop shared goals and work together to improve patient outcomes. This lack of collaboration can prevent the development of value-based care arrangements that align providers and payers around common goals. Until there is more collaboration between payers and providers, it will be challenging to create value-based care arrangements that meet the needs of patients in behavioral health care.

Value-based care arrangements have the potential to improve patient outcomes and reduce healthcare costs, but they aren’t as common in behavioral health care. The lack of quality measures, difficulties in predicting costs, underinvestment in behavioral health, regulatory barriers, and lack of collaboration are all contributing factors. To change this, there needs to be a concerted effort to develop quality measures that reflect the unique challenges of behavioral health, invest in behavioral health care, make regulatory changes that allow for more experimentation, and improve collaboration between payers and providers. By addressing these issues, we can create value-based care arrangements that work in behavioral health care and improve the lives of those with mental health and substance use disorders.