Key Pain Points in the U.S. Behavioral Health Industry for 2024 and Beyond

The United States is experiencing an opioid epidemic and mental health crisis. While the COVID-19 pandemic certainly made both issues worse, neither were new occurrences. The first wave of the opioid epidemic began in the 1990s. And even back in 2005, researchers were talking about the fact that more than half the people with a mental health condition do not receive treatment. There’s no doubt that behavioral health services have evolved for the better in recent decades. However, despite legislative reforms and countless new funding announcements and initiatives, by most accounts, the system remains in crisis.

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Now, in addition to entrenched access and affordability issues, significant behavioral health workforce challenges are emerging across the nation. A recent survey from the National Council for Mental Wellbeing found that 93% of behavioral health workers have experienced burnout, with 48% considering other employment options. Clearly, solving the mental health crisis in America will require a multi-level approach. One where policy and funding changes work alongside new practice models that support behavioral health clinicians to do their important work.

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As we all know, legislative and systemic change can be slow. However, there are options available right now to help providers deal with the workforce issues currently impacting the industry.

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In this article, we’ll explain how business process outsourcing (BPO) services, like those offered by Pharmbills, can help mental health and substance use treatment providers become more efficient and profitable while improving employee wellbeing and access to care.

An Overview of BPO Services

As any behavioral health provider knows, running a successful practice requires the input of a number of non-clinical staff.

With advances in technology, many innovative providers are now finding that outsourcing back-office tasks can help them focus on the high-value, high-impact work of delivering clinical care.

Three key benefits of BPO service are:

1. Staffing costs for non-clinical roles are significantly reduced, as it is possible to use offshore talent that is significantly cheaper than hiring local staff
2. By reducing administrative burden on behavioral health clinicians, efficiency and productivity can increase, while also reducing the risk of burnout
3. Money and time spent on back-office tasks can be redirected to more strategic endeavors, such as expansion or introducing new service offerings

BPO Roles Used by Behavioral Health Providers

Common roles and tasks mental health and substance use treatment providers may choose to outsource include:

• Coding and billing
• Data entry and records management
• Revenue cycle management
• HR and payroll
• IT and technical support
• Customer service tasks
• Records management
• Payment processing and billing

Behavioral Health Pain Points and BPO Solutions

Even though demand for mental health and substance use treatment services is set to continue increasing in the foreseeable future, that doesn’t mean providers can simply open up shop and expect to be successful. 

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There are several key pain points in the American behavioral health market at the moment, which if ignored, could significantly impact profitability for providers.

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In this section, we’ll explain the four key pain points for the behavioral health industry in the U.S. for 2024 and beyond. After each one, we provide examples of how BPO services for healthcare can help address these challenges.  

1: Clinician Stress and Burnout

During the pandemic, rates of burnout across the entire healthcare sector reached such high levels that the U.S. Surgeon General issued a special advisory on Addressing Health Worker Burnout.

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This is an important issue because as much as additional inpatient psychiatric beds and substance use treatment facilities are needed, without the staff to run them, they are of no use to people in need.

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Furthermore, the Surgeon General’s report highlights that worker burnout is a substantial financial risk for organizations. It cites the cost of managing staff turnover due to staff burnout among doctors and nurses as being $8.9 billion.

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What’s more, research shows the cost of burnout to behavioral health organizations may be even higher than for general healthcare. While around 50% of healthcare staff as a whole experience burnout, this number almost doubles, to 93% for behavioral healthcare staff.

Pharmbills Solutions

Both the U.S. Surgeon General and the National Council for Mental Wellbeing identify administrative burden as a significant contributing factor to health worker burnout.

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In particular, the National Council for Mental Wellbeing found that a third of the workforce report spending most of their time on administrative tasks. In addition, 68% of clinical staff said administrative burden takes away from time they could be spending on directly supporting clients.

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Now, in the modern mental health and substance use treatment systems, there is no getting around administrative work. 

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Medical coding and billing, patient notes, and maintaining electronic health records are all non-negotiable, so the only solution is to make the processes more efficient, with less burden on clinical staff.

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With our behavioral health BPO services, many back-office tasks can be reallocated from clinicians to low-cost outsourced workers, like:

• Insurance prior authorization
• Data entry for client records
• Appointment scheduling and tracking
• General customer service tasks

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Because outsourced administration staff are much cheaper than U.S.-based options, many providers find they can then divert additional resources to measures that will enhance clinician wellbeing.

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2: Ongoing Workforce Shortages

The crippling workforce shortages plaguing the wider healthcare system are just as bad for behavioral health providers - if not worse.

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In a Behavioral Health Business survey in 2023, 53% of providers identified staffing as the biggest challenge to the behavioral health industry. In terms of financial strain, 77% identified staffing changes as the biggest factor

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The only other factor that came close to staffing issues was reimbursement and payment challenges. However, considering that one of the biggest challenges with workforce shortages is increased staffing costs, one has to wonder whether reimbursement and payment challenges are a symptom, rather than a cause of workforce issues.

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Unfortunately, with 48% of the U.S. living in a mental health workforce shortage area - and shortages of psychologists, social workers, counselors, and psychiatrists projected to continue - this issue is not expected to resolve anytime soon.

Pharmbills Solutions

For now, one of the best options available to behavioral health providers for navigating workforce shortages is a staff augmentation strategy.

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When delivered via BPO services, staff augmentation involves the rapid deployment of external staff to help meet business needs.

Just a few examples of what this might involve are:

• Tech and administrative support to expand telehealth services
• Implementing processes for clinicians to delegate aspects of maintaining electronic health records
• Expanded medical coding and billing support
• Outsourcing intake and appointment scheduling tasks

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A big advantage for Pharmbills partners is access to the Pharmbills Academy. 

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Through strategic relationships with universities and training organizations, we can recruit staff who already have the knowledge and experience needed to help behavioral health providers rapidly address pain points. Because we manage these additional staff for you, there is no need to allocate internal resources to supervise outsourced staff. 

To get started, all you need to do is sign on with us and select your customized team. Then, we will manage ongoing service delivery and performance.

3: Delivering Affordable Care

While the Affordable Care Act and Mental Health Parity and Addiction Equity Act have helped expand access and coverage, reimbursement challenges continue to pose a barrier to delivering affordable care.

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Many mental health and substance use treatment providers face a common dilemma. Expand access by accepting insurance and receiving reimbursement that does not reflect the true cost of delivering care. Or, switch to private-pay only, in the knowledge that many would-be patients will no longer be able to afford their services.

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Surveys show that low reimbursement and administrative burdens are the main reasons behavioral health providers choose not to participate in insurance plans. And with reimbursement unlikely to catch up with the rise in staffing costs any time soon, more providers will switch to a private-pay only in the future.

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In practice, the most realistic option available to behavioral health providers for delivering affordable care is to increase the efficiency of clinical care systems. However, considering how stretched and overburdened clinicians currently are, doing this successfully requires a careful and well thought out approach.

Pharmbills Solutions

Some of the BPO services for healthcare providers we’ve already discussed in this article, like increasing administrative support, delegating back-office tasks from clinicians, and expanding medical coding and billing support can optimize billable clinical time. This can help organizations (and solo practitioners) to remain profitable while delivering affordable care.

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Another option is for behavioral health practices to expand the provision of telemental health services. 

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Clearly, there is unmet need for mental health services, especially in rural areas. Therefore, if mental health and substance use treatment providers can set up agile telehealth services with low overhead costs, the opportunities for growth are tremendous.

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With our offshore administrative and tech-support teams, Pharmbills are well placed to support behavioral health providers wishing to expand their service offerings into telehealth and digital mental health care.

4: Changing Consumer Preferences

Perhaps one of the biggest risks for behavioral healthcare providers today is keeping up with the changing expectations of healthcare consumers.

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We know from research on the healthcare system that people seeking care view themselves less as patients and more as consumers.

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In other words, presuming a person seeking behavioral healthcare isn’t hampered by access issues, they are likely to see themselves as an empowered consumer with a variety of choices. And now more than ever, there is a dizzying array of behavioral healthcare choices available in the market.

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Of course, consumers still want to know that the treatment on offer is evidence-based and safe. However, more and more, purchasing decisions are made on the patient experience, which is increasingly being recognized as an important component of high-quality care. 

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What this means for behavioral health organizations is it’s no longer enough to simply offer your service and expect patients to continue choosing you as their provider. To get the repeat customers that help a practice grow and become profitable, patients must be satisfied at all stages of the patient journey.

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The University of Utah distilled 15 years of research on patient experience into five key elements:

1. Caring - Does the provider care about me as a person?
2. Listening - Am I included in decisions about my care?
3. Explaining - Is my condition and treatment explained in a way I can understand?
4. Teamwork - Was the team friendly and organized?
5. Efficiency - Did I receive care easily, with minimal fuss and delay?

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Again, the effectiveness of treatment is important. However, it’s essential to recognize that most factors related to patient experience don’t involve the actual treatment being administered.

Pharmbills Solutions

The first reaction of most providers to discussions about patient experience is, “We don’t have time for all that!”

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Fortunately, many aspects of the patient experience in behavioral healthcare can be improved by non-clinical staff and digital health solutions. 

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Some examples of simple ways to improve patient experience are:

• Electronic systems for scheduling appointments and sending reminders
• A patient portal with online billing and payment functionality
• Providers offering the choice of online and in-person treatment options
• Easy-to-understand invoicing and insurance claims processes
• Responsive online customer support systems

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When you choose a BPO partner like Pharmbills, the majority of the above services can be delivered by offshore staff who are fully trained and qualified to perform their tasks, at a fraction of the cost of hiring new local employees. 

Seeing Opportunity in Challenge

There is no doubt about it, mental health and substance use treatment providers will be operating under challenging circumstances for the foreseeable future.

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Yet, with the U.S. behavioral health market set to increase from $91.41 billion to $136.6 billion in 2032, there are clearly opportunities in the market for innovative providers willing to explore new models of care.

Disruptive players have already begun entering the market by capitalizing on advances in healthcare technology, scaled data sharing, and cultural and behavioral change.

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These emerging industry leaders have developed new ways of working to deliver high-quality care more efficiently at a lower cost. This has the dual benefits of overcoming some of the longstanding access issues that have plagued the sector for decades, while at the same time developing a financially sustainable business model.

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If you would like to find out how BPO services for healthcare can help your behavioral health organization deliver better care, more efficiently, at a lower cost, contact our team to get started with Pharmbills today.