Elimination of Behavioral Health Wait Times: Impact on "Avoidable" Medical Visits, Productivity, and Revenues

Psychiatr Serv. 2025 Apr 1;76(4):398-401. doi: 10.1176/appi.ps.20240287. Epub 2025 Feb 13.

Abstract

Objective: Delayed access to behavioral health services results in poor outcomes and higher costs. This brief report describes the elimination of a 702-person behavioral health waitlist through phase-based care (PBC), an innovative approach that aligns behavioral health resources with new patients with high-acuity need.

Methods: Two PBC clinics, one triage and another high-acuity treatment, were established. Comparisons of pre-post interventions analyzed nonbehavioral health medical encounters, behavioral health productivity, and no-show rates.

Results: Of 702 waitlisted persons, 614 attended triage clinics within 3.5 months, with patients needing acute care (37%) entering the treatment clinic within 2 weeks. Following evaluation, the waitlisted patients had 23% fewer medical encounters per month (p<0.001), behavioral health revenues increased 29% (p<0.001), behavioral health visits increased 165% (p<0.001), health evaluations increased 287% (p<0.001), and no-shows decreased 33% (p<0.001).

Conclusions: Reallocating resources to new patients and those needing acute care resulted in increased behavioral health evaluations and productivity and reduced nonbehavioral health services without adding staff.

Keywords: Community mental health centers; Financing/funding/reimbursement; Phased-based care; Public-sector psychiatry; Quality assurance; Research/service delivery.

MeSH terms

  • Adult
  • Efficiency, Organizational*
  • Female
  • Health Services Accessibility* / statistics & numerical data
  • Humans
  • Male
  • Mental Disorders* / therapy
  • Mental Health Services* / economics
  • Mental Health Services* / organization & administration
  • Mental Health Services* / statistics & numerical data
  • Middle Aged
  • Triage
  • Waiting Lists*