Mental and Behavioral Health Consulting

How we see the Industry

The mental health market will face dramatic growth and evolution over the next ten years. Several factors are powering the change globally, with various dynamics impacting individual regions and countries in different ways, including:

• 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
• Dynamic public funding environments — with levels of attention and funding increasing for some countries or conditions and becoming constrained for others
• Reduced stigmatization of mental illness
• Increased incidence of many categories of mental illness, such as learning disabilities, autism spectrum disorder, personality disorder, neurological/neuropsychological conditions, etc., due to more excellent patient and clinician awareness
• Increased prevalence of dementia and related care needs
• Increased prevalence of substance abuse
• Improved mental healthcare delivery capabilities
• Undersupply of mental health professionals

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 many opportunities and challenges for providers, payers, and investors.

Questions we ask ourselves

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

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, etc.?
• 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)?
• How can we integrate physical and mental healthcare to benefit patients and caregivers?
• How can we take full advantage of risk-sharing opportunities for complex populations?
• How should shifts toward outpatient and/or community-based care settings influence investments?
• In the U.S., what are the optimal in-network (and associated requirements to measure and report outcomes) and private pay strategies?

Payers

• What are the most attractive opportunities for membership growth given both increasing managed care penetration of complex populations and state integration of physical and mental health programs?
• How can we most effectively support provider integration of physical and mental health and measure outcomes?
• How can we deal with a shortage of mental health providers and difficulty providing adequate access? How can we effectively deploy telehealth and improve step-down to the community setting?
• How should we reconcile and deploy both care management and provider support across additional and less complex populations?
• How can we develop and deploy provider reimbursement models that effectively align pay with performance?

Investors

• Which mental health provider segments represent opportunities?
• What is the outlook for reimbursement rates and contract structures?
• Will providers be able to expand and deploy services outside of their current footprint?
• What are the opportunities to drive economies of scale?
• How are providers using tech-enabled service providers to differentiate between payers and patients?
• In the U.S., what is the potential impact of federal legislation (e.g., ACA repeal), and how will the increasing pressure to be in-network with major payers manifest itself?

Examples of our work