EP298: The Intersection of Value-Based Payments and Behavioral Health—Also, the Rise of Telepsychiatry, With Don Fowls, MD

In Episode 298, Stacey Richter talks with Don Fowls, MD, psychiatrist and health care consultant, about where value-based payments and behavioral health intersect — and why telepsychiatry has taken off so fast during COVID.

WHAT YOU'LL LEARN

✅ Why the debate over telehealth often glosses over what patients are actually being asked to get from a 7-minute specialist visit

✅ The difference between mental health and behavioral health, and why managing populations requires both

✅ What "good" looks like when payment is aligned with outcomes instead of volume

✅ The four pillars that become the outcomes framework for a managed population

✅ Why integrated data and industry stakeholder collaboration are essential to making value-based behavioral health work

WHY THIS MATTERS

Dr. Don Fowls pushes back on the idea that virtual care is inherently worse for patients who need connection, pointing out that we already lean on expensive fee-for-service specialists for brief visits that don't actually address an underlying epidemic of loneliness. Telepsychiatry has expanded access to mental and behavioral health services during COVID, and Fowls argues real progress requires integrating behavioral and physical health data and aligning payment with outcomes — not just adding more visits, virtual or otherwise.

=== LINKS ===

🔗 Show Notes with all mentioned links: Episode Page

🔗 Healthcare Industry Acronyms and Terms

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00:00 Introduction.

03:27 Is telehealth here to stay?

06:16 "Now there's coverage in these medical clinics that there never was before."

07:38 "It's really trying to align the payment with the outcomes and services provided."

08:51 What does good look like?

12:06 "It's getting … plan and provider focused on achieving an outcome."

16:43 Do you really see outcomes change after implementing value-based payments?

17:40 "What are we really trying to achieve with this population? It's really four things. And these become … the pillars for outcomes."

23:29 "Right now, there's still way too much 'more is better.'"

24:16 "Well, that's great, but how did they do when they left? That's what you really want to know."

25:43 What are the three major data sets?

27:15 How is the pharmacy going to be impacted in mental and behavioral health moving forward?

28:05 "If you have data and facts behind you, it always helps."