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There’s a lot of buzz in healthcare about the promise of value-based care (VBC) and how it can reign in skyrocketing costs, while delivering improved patient outcomes. And indeed, the move to VBC has yielded positive results in primary care and there are emerging alternative payment models in specialty care for other chronic conditions. So it’s only natural that VBC has come to knock on the front door of behavioral health. The question is: Are behavioral health providers ready to open it? And what awaits them on the other side?
In part it’s taken VBC a long time to make its way to behavioral health because – for better or worse – it’s different from the rest of healthcare. The “outsider” status of behavioral health providers is rooted in the historical fragmentation of the healthcare system that separates the mind from the rest of the body. This split has been perpetuated by health insurance carve-outs, weak enforcement of mental health parity, and low reimbursement rates. Behavioral health is further “othered” by virtue of the incredible stigma surrounding behavioral health conditions, major barriers to access, and the predominantly female-dominated profession.