People do not begin therapy hoping a score will change. They seek care because their lives have started to feel smaller and more constrained. Work becomes harder to manage, relationships strain under unspoken pressure, and even daily routines can feel overwhelming. Any serious conversation about value-based care in behavioral health has to start here, with lived experience, and then work its way toward measurement rather than the other way around.

Why Behavioral Health Has Struggled With “Value”

In much of medicine, value is relatively straightforward to define. A lab result improves, a hospitalization is avoided, or a clinical pathway produces a predictable outcome. Behavioral health rarely follows this pattern. Progress unfolds unevenly and often quietly, shaped by context, timing, and trust.

That complexity has slowed adoption of value-based models in mental health. Health plans need consistency and comparability to manage populations responsibly. Providers know that narrow metrics can miss the work that actually changes lives. Virtual care organizations operate between these realities, translating clinical nuance into scalable systems without flattening the experience of care.

Demonstrating this tension at the 2025 Behavioral Health Tech Conference (BHT2025), Wes Knepper of SonderMind observed that patients do not celebrate score changes. They celebrate what becomes possible afterward. Returning to work. Reconnecting with family. Regaining a sense of agency. The task ahead is not rejecting measurement, but redesigning it so those outcomes are visible.

From Symptom Scores to Functional Progress

Symptom improvement remains important, but it cannot carry the full weight of value on its own. A more durable approach looks at how people function over time and whether care supports sustained engagement rather than episodic relief.

Meaningful outcomes begin with better framing. Instead of asking only whether symptoms decreased, value-based models must ask whether members stayed connected long enough for care to help. Whether their capacity to participate in daily life expanded. Whether intervention reduced the likelihood of crisis escalation.

Some organizations are beginning to organize outcomes around broader domains such as:

• Functional capacity related to work, caregiving, and daily routines
• Continuity of engagement across episodes of care
• Progress toward goals defined by the member, not imposed by the system
• Reduction in avoidable high-acuity utilization through earlier intervention

These measures anchor progress in reality. They also create space for responsible innovation, including the use of artificial intelligence to synthesize narrative data from therapy notes and patient-reported feedback. When applied carefully, these tools can reveal patterns that standardized surveys often miss while preserving clinical judgment.

Broadening What Counts as Care

Value-based behavioral health also depends on a wider understanding of care itself. Therapy and medication remain foundational, yet they are not the only evidence-based supports that improve mental health outcomes. Speaking at BHT2025, Andy Kelly of Optum emphasized the importance of integrating structured self-guided practices, skills-based tools, and reflective activities into care models.

For virtual providers, this shift changes the center of gravity. Care no longer lives exclusively in the session. It extends into the moments between visits, where habits form and resilience is practiced. For health plans, it creates opportunities to invest earlier, supporting maintenance and prevention rather than responding only to acuity.

This expansion requires discipline. Interventions must be clinically grounded, accessible across populations, and clearly connected to an individual’s care plan. When that alignment is present, reach increases without sacrificing quality.

Interoperability as a Clinical Requirement

No value-based model can succeed if data remains siloed. Behavioral health providers were largely excluded from earlier infrastructure investments that enabled interoperability elsewhere in healthcare. The consequences are still felt. Fragmented records. Incomplete attribution. Limited visibility into outcomes.

At BHT2025, Marguerite Tuthill of Monument Health pointed to health information exchanges as a necessary foundation for change. For both virtual providers and health plans, interoperability is a clinical prerequisite that enables coordination, accountability, and integration with the broader healthcare system.

What Collaboration Looks Like in Practice

The next chapter of value-based behavioral health will be written through partnership rather than prescription. Progress will depend on shared risk, shared learning, and shared responsibility for outcomes that matter.

Successful efforts tend to align around a small set of principles:

• Outcomes reflect member priorities as well as clinical goals
• Payment models support longitudinal relationships
• Data infrastructure enables coordination rather than oversight
• Trust between plans, providers, and members is treated as foundational

Ultimately, value in behavioral health comes down to access to care that works. When meaning guides measurement and collaboration shapes design, value-based care becomes a driver of real impact rather than an administrative exercise.