King of Prussia, Pa.-based Universal Health Services has moved to expand its behavioral health continuum, including its acquisition of virtual therapy and psychiatry platform Talkspace.
Marc Miller, president and CEO of UHS, told Becker’s about what is driving the surge in behavioral health demand, how UHS is adapting its outpatient strategy, and the risks health systems face if they wait too long to expand capacity.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: Industry forecasts suggest outpatient behavioral health demand could exceed prior projections by as much as sevenfold by 2036. From UHS’ perspective, are you already seeing demand accelerate beyond what you expected a few years ago, and what trends are giving you the clearest signal?
Marc Miller: Yes. We are seeing sustained growth in demand for behavioral healthcare, and importantly, that demand is extending across the continuum and becoming more diverse in terms of the types and levels of support people need. This includes people seeking early intervention and outpatient support to individuals with more complex needs who require a higher level of care.
One of the clearest signals is the continued shift toward outpatient care. Patients and families increasingly want access to care that can be integrated into their daily lives, while advances in treatment and care delivery are enabling more people to be appropriately supported in outpatient settings. We are also seeing greater recognition that behavioral health is an essential component of overall health, which is helping reduce some of the stigma that historically prevented people from seeking care.
All of this is shaping how we think about expanding access. For example, UHS’ acquisition of Talkspace gives us an opportunity to create more pathways into care and make it easier for people to access support earlier, while also helping connect individuals to higher levels of care when their needs require it.
People deserve a system that is easier to navigate, connected across care settings and built around their evolving needs. That’s the future UHS is building.
Q: What’s driving this growth the most? Is it greater patient acuity, improved awareness and willingness to seek care, workforce shortages, reimbursement dynamics, or other factors — and which of those do you think the industry is underestimating?
MM: It is really a combination of factors. Greater awareness and willingness to seek behavioral healthcare is an important part of the story, but we are also seeing increasingly complex needs among people coming into care. Social and economic pressures, changes in family and community dynamics, and the continuing recognition of the connection between mental and physical health are all contributing to demand.
I think the industry may underestimate how much access itself influences demand. When people can find care more easily, understand what type of care they need and move between levels of care without unnecessary barriers, more people are able to engage in treatment earlier. That is a positive development, but it also means the industry must build capacity ahead of the curve.
We also cannot overlook the workforce. Expanding access isn’t just about adding locations or technology; it requires having talented and competent clinicians and multidisciplinary teams to deliver effective, high-quality care. Developing and retaining that workforce remains one of the most important factors in our ability to respond to growing demand.
Q: As demand continues to outpace available capacity, how is UHS adapting its outpatient strategy? What changes are you making around the workforce, care models, technology, access points, or partnerships to meet growing needs without compromising quality?
MM: We’re focused on building a more connected behavioral healthcare continuum that gives people multiple pathways into care and allows them to move more seamlessly between levels of support as their needs evolve. That means continuing to expand and strengthen our outpatient services while creating stronger connections between virtual care, outpatient programs, crisis intervention, inpatient treatment and ongoing recovery. Creating a longer-term relationship with an individual strengthens their capacity to have a successful treatment and recovery experience.
Our acquisition of Talkspace is an important step in that strategy. Talkspace brings a nationally scaled virtual therapy and psychiatry platform that complements UHS’ extensive network of behavioral health facilities and outpatient services.
Together, we are creating the nation’s first full continuum of behavioral healthcare services — expanding the ways people access care while creating a more connected experience across settings and levels of need. The integrated model also strengthens support for employers, health plans and community partners seeking scalable, evidence-based mental healthcare solutions.
Workforce development remains equally important. We’re continuing to invest in clinicians and care teams, creating environments where they can practice at the top of their capabilities and have the tools and support they need to succeed.
Overall, we are rethinking how behavioral healthcare is delivered. Talkspace gives us another important way to extend the continuum beyond traditional care settings while maintaining the clinical expertise and quality of care that patients expect from our facilities.
Q: Looking ahead five to 10 years, what do you think health systems and behavioral health providers need to do now to prepare for this projected surge? Where do you see the biggest risks if organizations wait too long to expand outpatient behavioral health capacity?
MM: Behavioral healthcare providers need to prepare for growth by offering more flexible, connected care options that support people across different levels of need and make it easier for them to enter care earlier.
That starts with the workforce, and the challenge is significant. Data shows substantial shortages across many behavioral health professions over the next decade, while about 40% of the U.S. population lives in a Mental Health Professional Shortage Area. We need to continue investing in clinicians, developing new models of care and using technology thoughtfully to extend the reach of our clinical teams.
And again, we need to rethink how and where care is delivered. Virtual behavioral healthcare can create another entry point for people who may face barriers to traditional care, while outpatient services can provide an important bridge between lower-acuity support and more intensive treatment.
The biggest risk in waiting on outpatient expansion is that we continue treating people only when they reach a crisis point. If we don’t expand pathways into care now, we risk longer waits, greater pressure on emergency departments and inpatient services, and more people going without treatment altogether.
The opportunity is to build the capacity and connections today that allow people to access support earlier and move through the continuum as their needs evolve — while maintaining the clinical quality and expertise that behavioral healthcare requires.
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.
