Health systems are increasingly moving behavioral health beyond clinical coordination and into broader financial strategy, with a growing focus on reducing total cost of care.
Across five systems, behavioral health leaders told Becker’s how they financially integrated behavioral health into their systems.
- Embed behavioral health across the organization
Health systems are moving away from siloed behavioral health departments and instead integrating it into primary care, ambulatory care and payer operations.
At Norfolk, Va.-based Sentara Health, behavioral health is structured as a horizontal service line connecting acute care, outpatient services and the health plan, said Tracey Izzard, vice president of behavioral health services.
Arpan Waghray, MD, CEO of Renton, Wash.-based Providence’s Well Being Trust said the system intentionally incorporates behavioral healthcare into operating budgets across care settings.
- Focus on total cost of care
Integration is increasingly tied to reducing avoidable utilization, ED visits and healthcare spending. Behavioral health conditions are associated with up to threefold spending increases among patients with similar physical disease burden, according to a 2025 study published in JAMA Network Open.
“Continuing to treat it as a one-off or an ancillary service — that’s where we continue to absorb all of that cost,” Ms. Izzard said.
- Align reimbursement with care delivery
Several leaders said integration models are more sustainable when reimbursement strategy is considered up front.
Aurora, Colo.-based UCHealth has focused on using collaborative care billing codes alongside traditional behavioral health reimbursement models, according to Elicia Bunch, vice president of behavioral health.
Outpatient behavioral health services and Medicaid-heavy populations continue to present reimbursement challenges.
- Diversify funding sources
Systems said philanthropy, community benefit investments and higher-margin services can help support behavioral health expansion.
At Danville, Pa.-based Geisinger, specialties including orthopedics and cardiology help offset behavioral health funding gaps, Dawn Zieger, vice president of psychiatry and behavioral health said.
Mass General Brigham leaders also pointed to interventional psychiatry and procedural behavioral health services as stronger reimbursement.
- Create cross-functional governance structures
Behavioral health integration is more sustainable when finance, operations and clinical leadership share oversight.
Sentara uses cross-functional committees involving CMOs, COOs and CFOs to guide behavioral health strategy, Ms. Izzard said.
Ms. Bunch added that behavioral health must remain part of executive-level strategic and financial planning to sustain long-term progress.
At the Becker's Fall Behavioral Health Summit, taking place November 4–5 in Chicago, behavioral health leaders and executives will explore strategies for expanding access to care, integrating services, addressing workforce challenges and leveraging innovation to improve outcomes across the behavioral health continuum. Apply for complimentary registration now.
