Payment Pillar
Payment Pillar
The Payment Pillar
Behavioral health is in crisis, and the way we pay for care is part of why. Action for Progress advances five pillars of reform — and it starts with payment, because every other fix runs through it.
Why payment first
Most spending lands in avoidable hospitalizations, emergency visits, and relapse. Yet fee-for-service pays for the next encounter, not the better outcome — so the care that keeps people well goes unfunded, and the system has no one accountable for the whole person.
"We have to align the reimbursement to pay for the treatments that actually show the greatest results."
— Patrick J. Kennedy, Action for Progress launch"Nothing's going to work unless we realign those incentives. It's absolutely critical that we do that."
— Robert F. Kennedy, Jr., U.S. Secretary of Health & Human Services, at the launchHow the Payment pillar works
A bundled, three-part model, built from the tools the system already uses — no new codes, no new software, no new money. Any practice can begin without changing how it bills.
Stays the same
Providers keep billing as they do today, through the same systems. Nothing to adopt to begin.
Paid up front
One payment, in advance, for a person's care — so providers can invest in access and stay with that individual over time. It is the accountability the HHS Secretary described at the launch: "you get paid one price … you follow that individual for three years, and you're responsible for all the cost."
Earned on outcomes
Preventing avoidable crises frees real money. That savings is shared back with the providers who earned it — so doing right by the patient is also what pays.
Why it can spread: it rides the codes every claim already carries, with a neutral methodology — Solventum's Clinical Risk Groups — doing the math. So it doesn't wait on a mandate. Plans and providers who have never trusted each other adopt it because the numbers work for both.
Five pillars
Reform advances across five fronts. Aligned payment is the one that makes the other four affordable.
Built and run by Healthsperien. Action for Progress operates through Healthsperien's Center for Behavioral Health, and this payment model is tested and scaled through its Invest for Progress collaborative.