From Consolidation to Innovation, Behavioral Health Executives Share Their 2021 Predictions

In 2020, the COVID-19 emergency turned the behavioral health industry upside down, impacting everything from reimbursement and revenues to service delivery and demand itself. In the year ahead, the coronavirus will continue to shape the behavioral space.

As such, behavioral health executives predict that technology and consolidation will take center stage in 2021. At the same time, they expect to see the explosion of innovative new solutions, agreements and delivery models, created out of necessity to solve some of the industry’s most pressing challenges.

You can find the predictions from several behavioral health CEOs and industry executives below. While most focus on the behavioral industry as a whole, Behavioral Health Business will also highlight substance use disorder (SUD) predictions specifically in a follow-up piece to be published later in this month.

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The behavioral health industry in the U.S. will be strained and tested like never before in 2021.

Directly attributable to COVID-19, we have witnessed significant growth in unmet need for behavioral health services because of pandemic-related anxieties, financial instability, isolation and the physical inability of patients to access the critical care they needed during a national health emergency.

The pandemic has also already crippled the financial positions of many local and state governments, requiring them to stretch limited resources further and further. If history holds true, health care, and especially behavioral health care, will see reimbursement rates and coverage dwindle.

That, coupled with the explosion in need for mental health and substance use disorder services, will mean we have to do much more with far less.

Fortunately, we will also see an increasing number of innovative and creative ways to meet these challenges. The adage “necessity is the mother of invention” will never hold truer for the industry than in 2021.

I predict providers, payers, patients and other stakeholders will develop solutions to these issues in novel ways that will become exciting, new standards of care in the future.

— Rob Marsh, SVP and COO at Kindred Behavioral Health

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The single biggest factor impacting the behavioral health profession in 2021 is COVID-19.

Specifically, the stressors associated with the pandemic have exacerbated, and in many cases, triggered new mental health conditions including addiction disorders. The pandemic, however, has also accelerated the adoption of telehealth services, with the result being an expectation and understanding of the access and convenience this method brings to consumers seeking care.

— David C. Guth, Jr., CEO at Centerstone

The biggest factor to shape behavioral health in 2021 will be navigating the “new normal.” Patients will continue to exercise choice in how they receive their care, but the COVID-19 pandemic is teaching us that we can reach patients in many ways that were not widely explored previously, including remotely, [using] telehealth rooms with remote staff, greater use of clinical apps and other innovations in care delivery.

I believe we will also see an increase in the number of mergers, acquisitions and affiliations, along with a continued infusion of private equity and venture capital dollars into the behavioral health space.

— Kevin P. Norton, COO at Centerstone

The race to solutions for access to care, engagement and treatment innovation and meaningful results to deal with the overwhelming demand for behavioral health services feels like our version of Operation Warp Speed.

Whether it is the $16 billion invested in adoption and growth of virtual and hybrid care models this year alone, health plans competing for member lives and dependable providers through alternative reimbursement models or almost daily announcements of another disruptive acquisition and merger, the behavioral health industry will be forever changed.

If I may make the analog, like Operation Warp Speed, the significant changes emerging in the specialty medical sector of behavioral health hold the promise of millions of lives changed.

— Debbie Cagle, Chief Marketing Officer at Centerstone

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One of the biggest factors shaping behavioral health in 2021 will be the continued surge in demand for mental health support.

The continued uncertainty in the world and economy that we’ve seen this year has led to significant spikes in depression, hopelessness and anxiety, and we expect this to continue through the entirety of 2021. On top of this, a Lancet Study recently revealed that 20% of those infected with the coronavirus are diagnosed with a psychiatric disorder within 90 days.

In response, I believe we’ll continue to see widespread adoption of virtual mental health solutions among consumers, providers, payers and employers alike. In particular, we’ll see the industry turning toward subclinical, preventive forms of mental healthcare — like behavioral health coaching — as a means to address the growing supply-demand imbalance in mental healthcare and meet the growing access challenges in this industry.

I also suspect we’ll see:

• An increase in market consolidation. I expect to see record numbers of acquisitions in this space as the large digital health companies (both public and private) recognize the need to add behavioral health to their offerings to deliver comprehensive care.
• A push toward integrated care. I suspect we’ll see significant innovation in 2021 to bridge the gaps between mental and physical health care through improved care navigation and coordination, data sharing and partnerships.
• More research. We should also expect to see a flurry of research being published on the effectiveness of preventative care, coaching and digital clinical models in mental health.

— Russell Glass, CEO of Ginger

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With so many people facing increased levels of anxiety and depression, COVID-19 has normalized mental health for much of our society – making it something that affects almost everyone, instead of just a select few. As a result, I think we’ll continue to see an increase in the demand for treatment and continued growth in telehealth options, which allow patients to access care from the privacy of their own home.

The nation, individual states and our industry need a smart, comprehensive strategy — with dedicated funding — to ensure our behavioral health care system can meet this growing demand. Now is the time to increase access – not restrict it by underfunding these critical services.

Behavioral health providers have worked hard to adapt to lockdowns and fear associated with the pandemic by making behavioral health services more accessible through telehealth and safe in-person visits, but many patients are uncomfortable or unable to access mental health care this way, leaving a big gap. Rural areas, where many of our facilities are located, are particularly challenged, and while telehealth continues to be a valuable tool, it doesn’t work for every patient.

I think we’ll see a continued focus on making telehealth accessible to all patients and increasing outpatient treatment options to meet the growing demand for care from individuals suffering from depression, anxiety, substance abuse and other conditions brought on by the pandemic. Now more than ever, the industry will need to advocate for mental health parity to ensure behavioral health doesn’t get left behind as states work to balance their budgets.

— Stuart Archer, CEO of Oceans Healthcare

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COVID-19 will continue to be the biggest factor shaping behavioral health in 2021, despite promising vaccine candidates set for release in the coming months.

Operationally, the acceptance of telehealth and e-health will force organizations to rethink how they deliver care and their traditional business models, which will be critical given the increasing demands of mental health needs as COVID-19 cases continue to rise. Technology is also likely to dramatically lower market entry barriers and drive competition at levels that will challenge historical market trends, and [it] could force further consolidation.

I believe the pandemic has the potential to further a long-held dream of dramatically reducing the stigma associated with behavioral health conditions, as this shared sense of struggle will begin to shift the dynamic, allowing others to fully recognize the importance of mental well-being.

— Wayne Young, CEO of The Harris Center for Mental Health & IDD

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With COVID-19, it has been a traumatic time for many. Individuals will need help coping with the after-effects, such as loss of loved ones, stress from loss of income, separation from friends and family, fear of getting ill and how to reacclimate once restrictions are lifted.

According to a WHO survey, the COVID-19 pandemic has disrupted or halted critical mental health services in 93% of countries worldwide, while the demand for mental health is increasing. 2021 will be a year focused on healing and dealing with the pent up demand for mental health services.

Telehealth is seen in some ways as a solution to all of our mental health problems. But the problem of enough access to providers didn’t really disappear. One provider can only treat some 5 to 8 patients every day, so there ultimately aren’t enough providers to treat everyone in need. As mental health gets more and more attention in 2021, there will be more efforts toward scaling therapists, as the massive provider shortage will unfold.

There are many articles about new apps or digital treatments to cure our minds but 99% lack any scientific data. What will be important in 2021 and the following years is scientific data that demonstrates how these new solutions really show effectiveness and long-lasting results.

And as the suicide rate keeps rising among young Americans, companies and insurance providers are addressing this issue for their employees and members. Businesses like CVS Health have stepped up with resources and support to combat the rising rates of suicide, and we expect to see more of these types of programs rolling out in the coming year from companies who are proactive and paying attention to the mental well-being of their employees.

— Kristian Ranta, founder and CEO of Meru Health