The Behavioral Health Ecosystem Is Still Out of Alignment

Key Takeaways

  • Behavioral health demand is increasing, but the supply of point solutions remains fragmented.
  • Health plans need a central ‘switchboard’ to optimize untapped provider capacity with member demand.
  • True optimization delivers the right care faster, assessments across acuity levels and outcomes data that drive treatment.

Over the past few years, we have seen a tremendous increase in investment (both private and government-funded) in behavioral health solutions and services. Despite this, the mental health crisis continues. 

We believe a big part of the problem is that the behavioral health ecosystem is out of alignment.

There are two sides to the behavioral health ecosystem: Demand, driven by patients’ need for mental health care, and supply, referring to available, accessible delivery of care. Demand and supply need to be balanced, but this is not currently happening in behavioral health. Demand is increasing at an unprecedented rate, and despite the explosion of behavioral health startups and point solutions, supply remains fragmented. 

Challenges in the Behavioral Health System

Health plan departments responsible for managing member behavioral health needs have limited real-time visibility into provider networks. As a result of lagging data, they cannot effectively connect members to care. Instead, it’s often on the member to identify their mental health needs and contact providers to find an available appointment. Even where health plans have expanded their solution set, members need help finding the right provider or solution to treat their needs.

The lack of alignment across member demand and provider supply compromises our ability to get out of the crisis phase. Members either don’t get treatment or pick the first treatment available, which can exacerbate symptoms and cause members to restart their search for care—delaying a resolution and driving up costs. Providers, in turn, are frustrated because they’re not proactively managing their patient pool to drive positive outcomes. The quality of care and outcomes go down, and the upward ripple effect on the total cost of healthcare continues.

Optimization Aligns Supply and Demand

Health plans need a central ‘switchboard’ that aligns supply with demand and optimizes the flow of care. Optimizing behavioral health allows members to have the most direct path to finding the right treatment for their needs. It means that providers are managing the profile and number of patients they treat, leading to a higher likelihood of positive outcomes.

“Health plans need a central ‘switchboard’ that aligns supply with demand and optimizes the flow of care. Optimization means making effective use of a situation or resource.” – Sarah Reilly – SVP, Product & Strategy

What is needed to optimize behavioral health?

People with deep domain expertise who can screen and triage members, personally navigate them to the right care, and provide the necessary case management and ongoing support.

Technology with real-time operational capabilities in pooling across all providers (independent, small group, large group, aggregator, point solution and specialty) to centrally manage scheduling, outcomes measurement and care management.

Real-Time Insights to understand the interplay across demand and supply for better matching of members to care, capacity planning and network management.

What happens with optimization?

Comprehensive assessment across acuity

Health plans can clinically assess all members needing behavioral health care—from the mildest to the most complex—and direct them to it. Some point solutions or provider networks do this, but there’s no consolidated ‘front door’ for all health plan members.

The right care delivered faster

With consolidated visibility into overall provider capacity and provider-level appointment availability, plans can schedule appointments when providers are available.

Data-driven adjustments on a small and large scale

Using standardized measurement-based care tools, the patient profile, provider profile and outcomes data, health plans can dynamically update their provider networks to be responsive to member needs.

Together, We Can Optimize Behavioral Health

Lucet is building an optimization infrastructure to align the flow of behavioral health services across health plans and provider networks, and allow for timely access to value-driven mental healthcare for all who need it. In our work supporting health plans to optimize their behavioral health systems, we’ve uncovered 44% additional provider capacity without adding a single additional provider, and connected 55% more people to care. For each person in care, we’ve improved mental health scores by 40%. And using our scheduling platform, we’ve connected members to their first therapy appointments in an average of five days, and as little as one day.

Change is possible. It's up to us as leaders to identify and make the most out of these opportunity gaps if we want to address the mental health crisis in a more impactful way. By aligning and coordinating how member demand and provider supply work together, health plans can unlock potential value waiting to be utilized and transform the fragmented behavioral health ecosystem into something greater.