Olivia Davis is a senior executive overseeing health plan partnerships, network strategy, and communications at Headway, the largest mental health provider network in the country with more than 48,000 providers across all 50 states and the District of Columbia. Headway is building a new mental health care system that everyone can access by making it easy for therapists to accept insurance and run their private practice.
Health Evolution interviewed Olivia about Headway’s approach to advancing mental health access, the challenges and opportunities in measuring quality for mental health services, and perspectives on how to partner across the health care ecosystem to bring clinical excellence to scale.
It’s great to speak with you today, Olivia. As you know firsthand, improving mental and behavioral health is a major area of focus in the Health Evolution community. How are you seeing leaders across health care collaborating to expand access to mental health care?
Headway was founded in 2019 to solve the problem of fragmentation in mental health. More than 80% of outpatient mental health providers are solo practitioners, which has made it really challenging to connect them into health plan infrastructure and broader integrations with health systems. Headway’s model creates connective tissue between these fragmented groups, making it easier for mental health providers to first-and-foremost practice in-network.
As a result, we’ve seen speed to care increase by more than 10-fold, from pre-pandemic industry averages of 67 days down to fewer than 5 business days among Headway users.
As leaders have worked to expand access and bring attention to mental health on par with physical health, what interrelated challenges have we collectively uncovered? What do you see as the next opportunities for collaboration at an industry level?
We’ve made some strides on access, but most of the progress has been concentrated among commercially insured Americans and hasn’t been equitably distributed across all lines of business. There’s still a lot more to be done for our seniors and historically underserved communities, which is why Headway announced its expansion to Medicare Advantage and Medicaid earlier this year.
That said, enhanced access is the critical foundation to build on. With an accessible network we can start to think about how to most effectively understand clinical quality and the impact of behavioral health on physical health. Clinical literature has shown us that behavioral health care has an enormous influence on physical and functional health outcomes, but without reliable access, it’s been hard to quantify. As we continue to improve access, we can more effectively measure care outcomes along with the value behavioral health services can drive.
I’m so glad you highlighted the challenge of measuring outcomes – that has been a major area of exploration in our Roundtable on Innovations in Mental and Behavioral Health this past year. In fact, creating a robust data infrastructure is the very first principle in the new framework for instilling accountability that you all helped develop as part of the Roundtable. How do you see this playing out in practice?
The mental health care system faces persistent challenges in creating a unified framework for data measurement and infrastructure. One significant barrier is the technological gap; many organizations operate on outdated systems that are not interoperable, preventing seamless data sharing and analysis. This causes fragmentation of data across different stakeholders—providers, health plans, and patients—making it difficult to establish a cohesive understanding of patient outcomes. And finally, there is a need for a new generation of quality metrics to assess the effectiveness of care, which limits the ability to compare and improve services across settings. These issues collectively impede progress toward value-based care and hinder efforts to address disparities in mental health treatment.
This is where measurement innovations come into play. Initiatives like the National Quality Forum’s (NQF) Aligned Innovation program are working to develop healthcare quality measures that are meaningful to both patients and clinicians. By fostering collaboration among stakeholders, these efforts aim to bridge the gaps in our system, creating tools that providers can seamlessly integrate into their practices.
Headway is participating in the initiative, alongside 100+ of our providers as key partners. When clinicians are directly involved in shaping these measures, the results are not only more practical but also more likely to drive meaningful improvements in care.
Needing to standardize and rightsize the number of clinical measures is a key theme right now in both mental and physical health care. What would this new generation of measures look like?
We need to be working together across the health care industry to make this happen at scale. NQF’s Aligned Innovation aims to create a singular set of patient-reported symptom and quality of life outcome measures that evaluate treatment effectiveness and progression for depression and anxiety. We’re also designing these measures to be applicable across a range of patient populations, including children, adolescents and adults.
One of the main distinctions is we’re building a tool that goes beyond traditional symptom reporting. The measures will track functional health outcomes like quality of life, personal relationships, and employment, to offer a more accurate reflection of meaningful recovery in mental health.
Furthermore, a big part of this effort is about making sure the anonymized data providers collect is meaningful, with clear insight into disease remission and its impact on patients’ lives. These kinds of measures would empower providers with a more holistic, reliable understanding of their patients’ needs and progress over time. Ultimately, the new measure set should be easier for providers to use, and it should credibly demonstrate the extent to which patients are getting better and feeling better over the course of their treatment.
Thank you for your leadership in helping improve mental health care. As we close out the discussion, what are your top three recommendations for how health executives can be more effective partners in cross-industry collaboration, especially regarding mental health?
First and foremost, it’s crucial that mental health providers and patients not only have a seat at the table, but their perspectives are leading the conversation. In grappling with some of these really tangled systems-level problems, we as health executives tend to put greater emphasis on the actions of large institutions and major industry players, and that can result in losing sight of the individual human experiences and interactions that are at the heart of delivering medical care.
A second lesson, and this is related, is that most of these cross-industry collaborations are trying to motivate behavior change at some level. Changing behavior is hard, but there’s a growing movement in human-centered design that can help guide new processes, products, or services to be easier and more intuitive to use. Good innovation should feel like a relief or even a source of delight for the end user, not a burden.
Lastly, I’d say it’s important for us to remember that we’re not doing this in a vacuum. The evolution toward tech-enabled, measurement-based care has been happening for decades in the physical health specialties. As we focus on mental health, we can learn a lot from what worked, what hasn’t, and where there are the opportunities for shared wins across patients, providers, plans, and other industry groups.
