By Joseph Landin, CEO – Sanctuary Recovery Centers

For decades, behavioral healthcare has largely operated under a fee-for-service model.

The equation was simple: More sessions. More days in care. More billable services.

But healthcare is evolving, and mental health and substance use disorder treatment must evolve with it.

The future of our field will not be defined by how many clients we serve.

It will be defined by the outcomes we produce.

The Problem With Fee-for-Service

Fee-for-service reimbursement rewards activity.

It compensates providers based on:

• Length of stay
• Number of therapy sessions
• Units billed
• Program participation

But it does not inherently reward:

• Symptom reduction
• Functional improvement
• Reduced hospitalizations
• Sustained recovery
• Family stabilization
• Long-term engagement in care

In other words, it pays for services rendered, not lives improved.

When treating individuals with co-occurring mental health and substance use disorders, this misalignment becomes even more significant.

Because stabilization is complex. Progress is multidimensional. And outcomes must reflect both mental health and substance use improvement.

Value-Based Care Changes the Question

Value-based care shifts the focus from “What did we bill?” to “What changed?”

• Did depression and anxiety scores improve?
• Did substance use decrease or stabilize?
• Did emergency department utilization decline?
• Did clients maintain housing?
• Did family systems strengthen?
• Did engagement in outpatient care continue post-discharge?

These are the measures that matter.

At Sanctuary Recovery Centers, we believe behavioral health must be measurable, accountable, and outcome-oriented, not just compassionate.

Compassion is the foundation. Measurement is the responsibility.

Co-Occurring Disorders Require Integrated Accountability

A large percentage of individuals seeking care are navigating both mental health challenges and substance use disorders simultaneously.

Treating one without measuring the other leads to incomplete recovery.

Value-based behavioral health requires:

• Validated clinical assessment tools
• Ongoing symptom tracking
• Functional outcome monitoring
• Relapse prevention metrics
• Long-term engagement follow-up

When we integrate data across both domains, mental health and substance use, we can see patterns, adjust interventions, and improve stability in real time.

That is how clinical care matures.

Why Payers Should Reward Measurable Impact

Behavioral health conditions drive systemic cost across:

• Emergency departments
• Inpatient psychiatric units
• Justice involvement
• Child welfare systems
• Workforce instability

When treatment is effective, these costs decrease.

Value-based partnerships create alignment:

• Providers commit to measurable outcomes
• Payers invest in programs demonstrating impact
• Communities experience reduced systemic strain

This model does not reduce care.

It strengthens it.

From Volume to Value

Historically, providers were asked: “How many beds do you operate?” “How many clients can you serve?”

Those are operational metrics.

The more meaningful question is:

“How many individuals are measurably more stable because of your care?”

Value-based behavioral health demands evidence:

• Reduction in PHQ-9 and GAD-7 severity scores
• Improved engagement in recovery supports
• Decreased relapse frequency
• Increased employment and educational participation
• Strengthened family functioning

This is not about replacing clinical judgment with spreadsheets.

It is about strengthening clinical care with insight.

The Leadership Imperative

Value-based care begins with leadership culture.

Executives must ask:

• Are we measuring the right outcomes?
• Are we transparent about performance?
• Are we investing in data systems?
• Are we willing to evolve?

Behavioral health can no longer remain anecdotal.

It must be analytical, adaptive, and accountable.

Not to satisfy regulators. But to better serve individuals navigating mental health and substance use challenges.

The Future of Behavioral Health

The next era of care will not be defined by census.

It will be defined by:

• Outcome transparency
• Integrated co-occurring treatment models
• Long-term engagement tracking
• Data-informed clinical adjustments
• Shared accountability between providers and payers

Mental health and substance use treatment deserve the same level of rigor as any other healthcare discipline.

At Sanctuary Recovery Centers, we believe healing should be both human and measurable.

Because the true measure of our work is not how many people enter our programs.

It is how many leave more stable, more supported, and more equipped for sustainable wellness.

— Joseph Landin CEO, Sanctuary Recovery Centers

Learn more at: www.sanctuaryrecoverycenters.com