Ep 20: Inside Behavioral Health Systems with Cathy Gilbert

Episode Description In this episode, Rachel speaks with Cathy Gilbert — Founder and Principal Consultant at CEG Health — about what's happening inside today's behavioral health systems from both the payer and provider perspectives. Earlier this year, Rachel and Cathy spoke about the Big Beautiful Bill, and that conversation opened up so many rich threads around contracting, payer relations, and system design that they kept going. They recorded a second conversation to dive deeper into those broader themes — and this episode is Part Two of that discussion. Cathy shares how value-based care is unfolding in behavioral health, the data and measurement challenges that make it harder to implement, the impact of insurer-owned clinics, and practical strategies for patients navigating access barriers in a system already stretched by workforce shortages. Key Topics Discussed The current state of value-based care in behavioral health and why implementation is still slow Challenges of measuring mental health outcomes and reliance on PHQ-9 and GAD-7 How eliminating prior authorization changed payer visibility into outpatient care Small-practice dominance in behavioral health and inherent capacity limits Operational ways technology can genuinely support small practices (online scheduling, integrated EHR tools, measurement automation) Insurer-owned clinics in pharmacies and big-box settings: access benefits vs. workforce limitations Workforce pipeline issues, provider retirements, and psychiatry shortages Cultural expectations in the U.S. around speed, cost, and "the best care" Practical strategies for patients to access care within a constrained system Articles Mentioned Evernorth Study on Behavioral Health Value-Based Care https://www.fiercehealthcare.com/payers/evernorth-study-look-progress-toward-value-based-care-behavioral-health Times Union — Congressman Pat Ryan Releases Optum Health Survey Results https://www.timesunion.com/health/article/optum-survey-results-pat-ryan-20255087.php Connect with the Guest Cathy Gilbert Founder & Principal Consultant — CEG Health Website: https://ceghealth.com/ LinkedIn: https://www.linkedin.com/in/cathy-gilbert-29648421/ Connect with The Mental Health Evolution Connect with The Mental Health Evolution Website: The Mental Health Evolution Podcast Instagram: @mentalhealthevolution LinkedIn: Mental Health Evolution Facebook: Mental Health Evolution Music credit: Music by Zach Harrison