Advancing value-based behavioral health care through clinical collaboration

There is still a clear need for high-quality, evidence-based behavioral health care in the U.S. To achieve it requires collaboration among many stakeholders. We hear stories from clinicians who routinely see patients with complex mental health conditions, and who often have more than one¹. The health care industry, including CVS Health, has made big strides in making care easier to access and more focused on what works best for patients. But with one in five² U.S. adults experiencing mental illness each year, we know there’s work to do. We can improve quality by zeroing in on specific conditions. For example, 5.5 million Americans are affected by eating disorders each year, a condition that presents its own set of unique challenges. How can we improve the broader behavioral health care system to better address complex conditions like eating disorders?

One way to do so is through innovative payment models, including value-based models. Despite unique complexities within the behavioral health space, these models have started to show promise in improving patient outcomes. They also make it easier for patients to find and get the right care when they need it. Executing this model of behavioral health care starts with health plans and behavioral health provider groups aligning a shared vision of success. Admittedly, this can take time and can vary by provider or condition. However, the vision comes to life when advanced data and clinical outcomes guide collaboration, resulting in better care. With mutual trust and partnerships between payers, providers, and other partners, these models provide patients with better access, treatment, and satisfaction. Value-based models also require a shared focus on the importance of evidence-based outcomes, clinical care and agreed-upon best practices. CVS Health helps to ensure best practices remain at the core of this work.  By centering patient outcomes, value-based arrangements can facilitate better collaboration with aligned incentives.

Value-based care collaboration to treat eating disorders

The value-based care arrangement between Aetna, a CVS Health company and health plan, and virtual eating disorder provider Equip is an example of success. In 2021, we saw an opportunity to standardize outcomes, reduce the significant disruption that eating disorders were causing in our members’ lives and control costs. Since then, Aetna and Equip have reached more than 1,000 members across 47 states³. We’ve recently expanded our agreement, as a result of our successful multi-year collaboration, with a payment model that focuses on health outcomes and provides support for Equip’s comprehensive, multi-disciplinary care model. The model has now advanced to one that rewards outcomes over volume and shares risk. It’s shown how value-based care partnerships between payers and providers can enable access to quality behavioral healthcare that better serves people’s needs.

What’s working

In value-based care arrangements, providers are rewarded based on the quality of care they deliver. This creates a shared focus on quality and outcomes between the payer and provider. It can be especially helpful for managing complex conditions. Studies have shown that effective eating disorder treatment requires a holistic, outcomes-driven approach that goes beyond traditional metrics. That’s why Aetna and Equip have built a collaborative care model that prioritizes the full scope of recovery, including weight trajectory, eating disorder symptoms, discharge disposition and co-occurring mood conditions like depression and anxiety. Together, teams track progress using clinically validated tools such as the PHQ-8 (Patient Health Questionnaire) and GAD-7 (Generalized Anxiety Disorder 7-item scale) — both commonly used screening tools for mental health — as well as the EDE-Q (Eating Disorder Examination Questionnaire), which assesses the range and severity of eating disorder symptoms. These tools help us align on what recovery means for each member. This model and shared definition of success puts the member first, enabling us to deliver more consistent, member-centered care.

Aetna partners with Equip because its integrated, evidence-based model complements our strategy and creates positive patient outcomes. Equip’s personalized treatment plans combine therapy, nutritional counseling, medical care and peer support. This is all designed to meet members where they are and respond in real time to their evolving needs.

Measuring success

The results we’ve seen from the Aetna-Equip relationship so far speak to the potential of value-based care. As an example, Katie, a nursing student diagnosed with avoidant restrictive food intake disorder (ARFID) by a dietitian, recently shared her journey. Katie said that while she was fortunate to have a diagnosed condition, her dietitian was not an expert in this area, and she knew she needed specialized care. Through Aetna, she was connected with Equip’s  multidisciplinary provider team.

By the six-month mark, Katie had regained independence in her eating, gained weight, added exercise to her lifestyle and started to try new foods. Katie said her care was “evidence-based and lets people recover without putting their life on hold, which is rare in the eating disorder treatment world.” Katie’s story is one example of how effective clinical collaboration can create access to specialized mental health care and is a model demonstrating sustainable long-term, positive, patient-centric results.

Of the Aetna members treated by Equip since 2021, 86%⁴ have made progress in their eating disorder treatment and the average reduction in eating disorder symptoms is 70%⁴, validated by the Eating Disorder Exam Questionnaire (EDE-Q). In addition, the average reduction in depression and anxiety symptoms is 45%⁴, as measured by the PHQ-8 and GAD-7. Importantly, members were able to achieve these outcomes in the comfort of their own home, avoiding admissions to higher levels of care.

Delivering meaningful, sustained improvements in mental health care

Value-based care is a shift in behavioral health care. It’s redefining success beyond service volume to focus on contracting models that enable improved quality of care, better outcomes and reduced costs. Unlike traditional fee-for-service models that incentivize utilization, value-based care aligns reimbursement with the quality of patient outcomes. This model supports providers in delivering meaningful, sustained improvements in mental health outcomes and doing it more efficiently.

“Value-based care only works if we’re measuring what really matters: patient outcomes,” said Kristina Saffran, CEO and Co-Founder of Equip. “It provides a framework to align incentives around real recovery, not just session counts. For conditions like eating disorders, where the stakes are high and progress is complex, tracking outcomes isn’t just helpful — it’s essential. At Equip, we’re committed to measuring outcomes so we can continually learn, improve, and ensure care is truly making a difference.”

When done correctly, VBC collaborations have the opportunity to improve member outcomes, while creating a better experience for patients, providers, and employers. While this is one example, if we continue to work together with our provider partners to standardize outcomes, invest in data and technology, and share best practices, we can create repeatable clinical models and innovative alliances to transform mental health treatment.