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Scaling Behavioral Health: Building Sustainable Models in 2026 · Becker's Healthcare Behavioral Health

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Hello, everyone. This is Erica Spicer Mason with
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Becker's Healthcare. Thank you so much for tuning
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into the Becker's Healthcare podcast series today.
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So today, we're going to talk about scaling
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behavioral health and how health systems can design
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sustainable models for 2026
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and beyond.
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And joining me for this conversation, we have
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with us Adisa Shirley, the chief growth officer
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at Clinic Mind. Adisa, welcome to the podcast.
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Thank you so much for joining us today.
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Thank you so much for having me, Erica.
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So happy to have you, Adisa. And before
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we get into the conversation,
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would you mind sharing just a little bit
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more about yourself and the work that you
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do in health care?
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Absolutely.
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So my background is in behavioral health,
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of course, and my work has really lived
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at that intersection
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of clinical care operations
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and growth.
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I'm a clinician
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myself and,
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an IOS psychologist by training,
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currently serving as a chief growth officer at
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Clinic Mine.
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I've worked across behavioral health strategy,
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operational transformation,
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and also private equity related environment,
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which
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really gave me a front row view into
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what actually takes to scale organizations
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without
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losing
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that component
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of clinical
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integrity.
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So my perspective today is really shaped by
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both the care delivery side and the enterprise
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side,
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how you build models that improve access, stay
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operationally
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disciplined,
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and, of course,
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remain financially
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sustainable
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over time.
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At clinic mind, that really means focusing on
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the systems that are behind that care delivery,
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documentation, road flows, billing,
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operational efficiency
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so the clinicians
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can spend more time on doing what, they
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actually went to school to do. You know,
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spend time with patients and less time on
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the administrative button.
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Yeah. Well, it's great to learn more about
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you, Adisa, and I think you're bringing such
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an important perspective to the conversation today.
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You know, as we're seeing behavioral health care
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demand grow
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so much, that operational and financial sustainability perspective
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is so important.
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So before we go deeper on those areas,
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I wanna start with kind of the nuts
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and the bolts here.
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But where is behavioral health expansion breaking down
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in practice today, and what do you think
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leaders are routinely missing in this area?
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I
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think behavioral health expansion is breaking down because
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too many organizations are trying to scale services
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without scaling the infrastructure.
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So they add providers, they hire more people,
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they launch different programs,
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or grow to new sites and partnerships,
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but the underlying
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operating model
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remains or stays still fragmented.
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Reimbursement
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is fragmented.
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Intake is fragmented.
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Referral pathways are fragmented.
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And behavioral health is still too often treated
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as
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separate from the rest of the enterprise.
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I know that's something that Becker's has also
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highlighted,
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you know, some of the similar issues like
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fragment and payment,
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siloed care models,
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work for force shortages,
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documentation
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burden,
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outdated access pathways.
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And I would say one thing
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my private equity exposure
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reinforced
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for me is that
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growth amplifies
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whatever the situation is. So if something is
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already broken,
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growth just amplifies that. If governance is weak,
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if data is inconsistent,
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if workflows
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vary site to site,
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or if the care model is dependent
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on individual effort,
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those problems
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become such
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a more such a bigger or and more
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visible,
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as organization
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scale. So what leaders
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often miss is that behavioral health is not
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just an access problem. It's an integration
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and operating
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model problem.
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It's
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such a powerful
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insight, Adisa, that your PE exposure has reinforced
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that growth can actually amplify
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whatever the situation may be, including challenges. So,
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really important for, I think, listeners to hear
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and
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and kind of taking that a bit further.
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You know, if you were to put yourself
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in someone's shoes, a leader's shoes, an organization's
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shoes that was looking to stand up a
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scalable behavioral health service line, what would those
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nonnegotiables
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be? Whether we're talking governance, access, operations,
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and what do you think leaders should keep
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in mind there?
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So if I were building a scalable,
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service line today, behavioral health one especially,
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I would focus on three nonnegotiables.
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One, governance.
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Second, access.
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And then third,
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operational standardization.
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So with governance,
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it has to be real. So behavioral health
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needs executive ownership and
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cross functional
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accountability.
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It cannot
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sit off to the side. So clinical leadership,
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finance,
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operations,
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and quality
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all need to be looking at the same
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priorities
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and the same data.
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One thing private equity environments tend to make
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very clear is that you cannot scale what
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you cannot govern, and you cannot govern what
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you cannot measure consistently. So that would be
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the first one.
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Second,
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access has to be intentional.
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Access does not just mean hiring more therapists.
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It means clear triage
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pathways,
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reduced time to first appointment,
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smart use of telehealth,
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strong referral management,
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and community partnerships
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that
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keep it from becoming
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the default behavioral health
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access point.
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I know Becker's has also, you know, highlighted
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the importance
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of integration prevention,
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community collaboration.
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I do kinda keep up with your guys'
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articles that you guys publish.
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And then third one, you know, operations have
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to be standardized
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enough to scale,
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which means
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documentation,
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scheduling,
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referral closure,
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revenue
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cycle, quality reporting, you know, BI dashboards,
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and health IT all need to support the
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care model
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instead of slowing it down. So from a
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boat, an operator lens, and, an investor lens
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or private equity lens,
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sustainable growth comes from reputable
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systems,
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not one off
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workarounds.
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And then in terms of success metrics, I
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would watch access, engagement,
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safety,
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clinical outcomes,
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and financial performance together.
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Because
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if we're looking at just 2026,
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growth alone is not the signal of success.
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It's durable performance.
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I've I've seen, you know, over the years,
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behavioral health from both the care delivery side
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and the enterprise value creation side. And
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the biggest lesson that I have learned and
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some of my clients have learned is that
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sustainable scale really depends
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on that operational discipline.
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Such a helpful overview, Adisa. And by the
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way, I have to say, I love that
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you're a Becker's healthcare reader. So thank you
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for, you know, confirming that some of the
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trends that you're picking up on in our
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coverage align with what you're seeing in the
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field,
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and great great notes about governance, access, and
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operations here and what leaders need to be
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looking at and measuring.
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And I know that also CMS
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has revealed,
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an innovation and behavioral health model. So I'd
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love to know from where you stand, how
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do you think
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systems and community practices should prepare for that
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new model,
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And what should markets outside of those pilots
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do now to really stay aligned?
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The biggest takeaway from the CMS innovation and
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behavioral health,
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model is that the future is integrated,
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measurable,
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and much more coordinated than
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what many organizations
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did in the past,
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and that many of their organizations are actually
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doing today. So CMS is putting specialty behavioral
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health providers at the center of value based
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whole person care for adults
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with moderate to severe mental health or substance
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use conditions
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with support for health IT,
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interprofessional
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care teams, screening,
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social needs coordination,
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and aligned payment approaches
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across Medicaid and Medicare.
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And that model runs from 2025
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through 2032
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with infrastructure building happening ahead of the full
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implementation.
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So
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for systems and community practices,
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the preparation
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work should already
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be underway.
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That means
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strengthening coordination with primary care and community partners,
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improving
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closed loop referrals,
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getting more disciplined about screening and follow-up,
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and
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making sure that the documentation
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and reporting can support quality measurement
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and, future value based arrangements.
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And I would also mention here, like, BI
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dashboards, making sure that there's that you have
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a good visibility to what is actually happening
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in your business.
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And for markets outside the pilot,
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I would not wait.
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Even if they're not formally
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participating,
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the model
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is still a signal about where the policy
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and payment
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are heading. So even outside those pilot states,
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leaders should really act like this future is
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already here.
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Yeah.
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Really, really helpful intel, Adisa.
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And before I let you go, I I
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wanted to also touch on something that you
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mentioned earlier in one of your responses. You
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had touched on telehealth,
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and we see that recent data shows
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almost thirty percent of adult outpatient mental health
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care is delivered via telehealth.
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And Medicare also added twenty twenty five coding
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updates to really strengthen crisis follow-up and safety
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planning.
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So given those shifts,
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what do you think is the future of
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behavioral health? What does it look like from
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your perspective as a clinician and also with
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your focus at Clinic Mind?
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And I know I know you've shared that
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about 28
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of adult,
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outpatient mental health care is delivered via telehealth.
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Most of the practices I work with, it's
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probably more than 80%.
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So I think there's some of the practices
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that are fully,
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in person that are balancing that out. But
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from my perspective, the future of behavioral health
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is hybrid.
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It's not a debate between in person and
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virtual anymore.
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It's about using the right modality at the
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right time for the right patient.
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You know, again, I'm gonna go back to
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Becker's. No. You guys have recently reported,
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you know, some of the numbers, like, on,
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how much,
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how much care is actually delivered by telehealth.
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And I know there was also a
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number related to a hybrid model, which is
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about twenty one percent
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of the patient that are,
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that are seen via that hybrid model. And
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that really tells us that virtual care is
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no longer
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temporary. It's a part of permanent access,
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strategy.
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I would say,
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clinically, that is important because telehealth can improve
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continuity,
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reduce barriers,
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and make follow ups more realistic.
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If we're thinking about some of the suburbs
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or some of the areas where
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they do not have the ability to get
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to the provider every single week if they're
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seeing a therapist, for example,
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Telehealth provides a really nice option for them
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to continue care
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even when they're not able to get in
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a car and drive to the therapist.
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Mhmm. And policy is really moving in, you
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know, to support that. So CMS continues to
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allow behavioral
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health, telehealth in the home without geographic restrictions.
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And then also Medicare's 2025 updates added payment
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support for things like safety planning interventions and
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post discharge,
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follow-up,
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which is a meaningful
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step because good behavioral health is not just
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the visit itself.
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It's what happens before
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and after the visit as well. And if
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I tie that to what we're doing in
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ClinicMiner and ClinicMiner's side, I think the real
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differentiator
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will be whether organizations
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have that infrastructure
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to make that model work.
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Hybrid care can only scale when
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scheduling, documentation,
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coding, billing,
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patient engagement
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are working together.
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Otherwise,
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telehealth
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adds convenience
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on the front end,
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but it adds a lot more complexities
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on the back end.
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So
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if I summarize it, the future of behavioral
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health to me is hybrid care supported by
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smart operation
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and good infrastructure.
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Yeah.
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Adisa, it's been great getting your perspective
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on
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not just how you see behavioral health access
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changing in the years ahead, but what's really
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needed as the foundation
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to expand access and to your point and
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everything that you've said about operations and infrastructure
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being
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the keys to that. It's so helpful and
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insightful, and I just wanna make sure is
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there anything else that you wanted to touch
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on that maybe we glossed over too quickly
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in our conversation today or any final thoughts
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you wanted to leave listeners with?
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No. I mean, I think I think the
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biggest thing I would leave with is
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that scaling behavioral health is not the same
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as expanding
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behavioral health.
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Expansion is adding access points.
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Scaling
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means it's more building a model that keeps
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working as demand grows, so clinically, operationally,
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and financially.
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I would also say that this is an
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exciting moment for behavioral health. There's more urgency,
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more policy attention,
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more willingness
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to rethink outdated care models
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than we've seen in a very long time.
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So
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the question now is who can translate that
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momentum in the execution, and that's what we're
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working through now. And in my opinion,
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you know, I'm probably biased because I'm a
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clinician myself, but this is a very exciting
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time for us, and, I'm really excited about
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what the future holds for behavioral health.
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Yeah. Well, I so appreciate
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your passion behind this work, Adisa, and everything
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that you've shared with us today from the
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clinician standpoint and from where you sit at
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Clinic Mind,
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so helpful to hear what you see on
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the horizon for behavioral health. So thank you
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again for spending time with Becker's today.
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Thank you, Erica. Thank you for having me,
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and thank you, Becker's, for providing an opportunity
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for this conversation.
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Of course. And we'd also like to thank
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the podcast sponsor for today, Clinic Mind.
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Listeners, be sure to tune in to more
15:58
podcasts from Beckers Healthcare by visiting our podcast
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page at beckershospitalreview.com.