The mental health market is facing dramatic growth and evolution. There are several factors which are powering the change globally, with various dynamics impacting certain regions, specialties and individual patient acuity.

• Reduced stigmatization of mental illness
• Government and healthcare industry recognition of mental health issues, and resulting regulatory and policy responses (e.g., Mental Health Parity and Addiction Equity Act, integration of Medicaid funding streams) and increased levels of dedicated government funding as well as PPO/HMO Coverage without limitations placed on number of visits
• Increased incidence of many categories of mental illness, such as learning disabilities, autism spectrum disorder, personality disorder, neurological/neuropsychological conditions, military, pandemic, sexual identity, gender, victim, chemical dependency, etc., due to greater patient and clinician awareness
• Increased prevalence of substance abuse
• Improved mental healthcare delivery capabilities
• Undersupply of mental health professionals
• Start up and growing of one’s practice or clinic
• Marketing and business development (e.g., referral base )

The resulting demand growth for mental health services, combined with the need for improved outcome measurement and the requirement for integration with physical health providers brings a host of opportunities and challenges for providers and payers.

As mental health assumes an increasingly prominent role in the healthcare system, we help organizations address a range of key issues:

Key questions and challenges Providers

Which markets have the greatest unmet demand based on patient population growth, reimbursement/payer dynamics, competitive dynamics, quality of the supply-side response, policy frameworks, regulatory landscape?

Which levers can we pull to improve performance (e.g., greater service line specialization, pathway integration, enhanced reimbursement, improved staffing models, improved clinical practices, enhanced technology, location of practice or clinic, networks, community involvement)?

How can we integrate mental healthcare for the benefit of patients and caregivers?

How can you take full advantage of risk-sharing opportunities for complex populations?

How would a shift toward outpatient based care settings help the patient?

In the U.S., what are the optimal in-network (and associated requirements to measure and report outcomes) and private pay strategies?

Does hiring a billing service pay for itself instead of providers billing for one self, cost, time spent, recoupment.

What are the most attractive opportunities for membership growth given both increasing managed care penetration of complex populations and state integration of substance abuse and mental health programs for Network Participation?

How can we develop and deploy provider reimbursement models that more effectively align pay with performance?

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