Behavioral Health Trends to Watch in 2022: Innovation from Payors, Shifting Focus from Access to Quality of Care

The nation’s behavioral health industry keeps growing, with current estimates pegging it to be worth $90 billion. And for those on the frontline advocating for the industry, it is an especially busy time.

Like everyone else, the ongoing – and seemingly neverending – pandemic remains front-and-center in the consciousness of behavioral health leaders, as they watch conditions like stress, anxiety and depression rise nationwide. Then there are other developments that leaders are watching and are tasked with helping the industry navigate in the new year, such as telehealth adoption, payer-provider relationships, workforce issues and the soon-to-be unveiled 988 crisis line number.

Whether it is mental health counseling, substance use disorder treatment or applied behavioral analysis therapy (ABA), leaders across the behavioral health spectrum expect 2022 to be yet another impactful one for the industry, complete with challenges and opportunities. Behavioral Health Business spoke to some of those industry leaders at trade groups to get their take on what to look out for.


As the world enters the third year of the Covid-19 pandemic, the need for behavioral healthcare services in the United States is stronger than ever. Our members have indicated the greatest challenge they will face in 2022: workforce. Staffing needs—both in recruitment and retention— were causing problems for the nation’s mental health and addiction treatment providers before the coronavirus emerged, and the global pandemic has only worsened those problems. In the pandemic’s early days, our members pivoted quickly to implement infection-control practices and protocols while still providing care—either in person or through telehealth services. In 2021, federal vaccine mandates brought a new challenge to manage. We will work with our members to help navigate all of these issues.

In addition, we will work to build awareness about the 988 crisis hotline that will launch in July 2022. All of us in the behavioral healthcare segment agree that policymakers, the media, and the general public need to understand that this is more than a phone number. This hotline must provide a place to call, a person to talk to, and somewhere to go. We need to ensure there is a solid infrastructure to support this life-saving resource.

As we tackle these challenges, we will concentrate on improving access to care for America’s children and youth, many of whom are in desperate need of mental health and addiction-treatment services. We need to help lawmakers and the media understand the excellent care that our members provide through a range of services, from eating disorders and clinical depression to serious mental illness and substance use disorder.


– Shawn Coughlin, President and CEO of the National Association for Behavioral Healthcare

We will continue to see increased demand and spending for mental health and substance use treatment services in 2022 across all populations and payers with corresponding investment in technology-first solutions. We are hopeful for action on the federal level to allow all states to participate in the Certified Community Behavioral Health Clinics (CCBHC) Medicaid program, a step which has the potential to increase the capacity and health of the behavioral health safety net. There will continue to be a focus on supporting recovery-ready communities and services at the federal and state level, with the potential for more dedicated funding at the state level. Lastly, we will continue to see experimentation at the local level to address the overdose crisis including expansion of harm reduction strategies.

– Chuck Ingoglia, CEO of the National Council for Mental Wellbeing

2022 is going to be a big year for innovation by payors geared towards addressing the increasing demand for ABA therapy and the downward pressure of heightened utilization and lack of unified measures of patient outcomes. High-volume therapy industries like ABA will be asked to rethink how they demonstrate their value to patients. I anticipate payors will lean into relationships with ABA providers, creating value-based incentives to rely on already adopted industry standards and measures. This will all be on the table for development in 2022 and ABA providers should come with an open mind, ready to collaborate.

– Sarah Litvak, CEO of the Behavioral Health Center of Excellence

Next year, I predict that the conversation will evolve from access to care to quality of care. The question will no longer just be: “is our front door open to all people who need help?” The question will now become: “Are we delivering the right care to the right person at the right time?”

While the conversation on expanding access will continue, we will look more closely at the outcomes we are delivering. After all, what is the purpose of serving more people if the quality of care and desired outcomes aren’t being met? Delivering quality care will be a top priority in 2022, as the issue of opening up access to care continues.

The year 2022 will also bring in defined milestones and clear progress toward value-based care. There will be more pilots and programs of value-based reimbursement contracts between payers and providers. I predict that 10-15% of contracts next year will be value-based. The traditional fee-for-service model won’t disappear for years to come, but there will be thoughtful pilots of reimbursement programs that reward providers for quality of care and clinical outcomes.

– Eric Meier, President and CEO of Owl

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