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By ontrak

April 25, 2025

The Solution to the Mental Health Capacity Crisis is Behavioral Health Care Coaching

Judith Feld and Sylvia Rowlands | April 25, 2025 –

The doctor will see you…..in three months.

For the one in five Americans who need mental health care, this is a reality. Half of those in need do not receive necessary care, and the demand for these services continues to rise. [1]. Waiting for care isn’t just an inconvenience for patients- it also comes with a cost to employers and health systems. Unmet patient needs translate to disengagement from care and worsening of symptoms that lead to increased costs and demand for higher levels of care.

Traditional therapy models cannot scale fast enough to meet demand considering over a third of Americans lives in a mental health professional shortage area [2]. Experts report that COVID-19 exacerbated mental health issues, and a substantial shortfall of providers is projected through 2037 [2]. Without a new approach, mental health care needs will continue to escalate while the financial strain is already crushing our system. This is no cautionary tale of the future; we’re already absorbing $17.5 billion in emergency room overutilization $76 billion in mental health-related chronic condition expenses linked to health inequities like lack of access to care. Without action, these avoidable costs are projected to triple by 2040 [3,4]. Our current healthcare system needs an affordable, scalable care model that provides timely, person-centric, and structured support for non-emergency mental health concerns.

Behavioral health care coaching is emerging as a care model that meets the changing landscape. Coaching offers a personalized, evidence-based approach that helps individuals manage mental health and behavioral challenges through structured guidance, goal setting, and motivational change. Unlike traditional therapy, which is resource-intensive and requires extensive clinical training, coaching is more accessible and cost-effective. Behavioral health coaching can improve the provider access challenge by providing ancillary channels to enhance treatment outcomes or mitigate the need for specialty care.

As demand for alternative mental health solutions grows, payers recognize the value of behavioral health coaching through emerging reimbursement pathways. New Current Procedural Terminology (CPT) codes for health and well-being coaching introduced by the American Medical Association (AMA) and added to the 2024 Medicare Telehealth Services List signal a shift toward broader coverage. While these codes are classified as Category III–what are considered as ‘emerging’ technologies, services and/or procedures through 2027, they represent a critical step in legitimizing care coaching as an effective and reimbursable service. Some health plans have already begun covering these services, offering reimbursement rates comparable to Medicare Chronic Care Management programs. As data collection progresses, industry experts anticipate further expansion of payer adoption and a potential transition to permanent reimbursement models.

Amid the rapid growth of telehealth and digital platforms, care coaching expands access, presenting an attractive solution for health plans, employers, and systems aiming to meet demand while managing costs. Behavioral health coaching leverages synchronous (live sessions) and asynchronous (self-guided) communication. By combining interactive support with tools like app-based journaling and guided exercises, coaching programs empower individuals to engage with their mental health on their own terms. This blended approach enhances engagement, improves outcomes, and removes common barriers to care, such as inflexible scheduling, transportation, and high costs.

Part of what makes coaching so effective is that it is rooted in established psychological frameworks, including cognitive-behavioral techniques (CBT) and motivational interviewing. Because it is a clinically informed yet highly scalable solution, it aligns well with the industry’s shift to value-based care while addressing the systematic challenges of today’s mental health landscape. The flexibility of a coaching model provides:

Faster Access: Clients can connect with coaches within hours or days rather than waiting weeks for therapy [4].
Symptom Reduction: These programs have been shown to help significantly decrease anxiety and depression symptoms [5, 6].
Cost-Effectiveness: Studies show coaching reduces the financial burden on healthcare systems by up to 40% while maintaining high-quality care [7].
User Satisfaction: On-demand, flexible support, fosters long-term engagement and long-term adherence [8].
Scalability: Digital coaching platforms support large, diverse populations [9, 10].

A coaching model is particularly powerful in rural and underserved areas, where geographic barriers and provider shortages further restrict access to traditional care.

Opportunity for integrated chronic care management: Integrated coaching models can address the spectrum of physical and behavioral health conditions through tailored approaches to member engagement.

The first step for organizations considering a care coaching model is identifying the target population and aligning the program design with specific needs. Selecting a user-friendly, scalable digital platform and training coaches in evidence-based techniques and behavior change strategies is crucial. From there, integration with existing healthcare services ensures seamless escalation protocols for clinical care when necessary. Tracking metrics such as symptom reduction, cost savings, and user satisfaction is key to demonstrating ROI and building long-term support.

The deepening mental health crisis in America won’t be solved without new and innovative models of care. Without these models, more lives will be put on hold, more individuals will struggle without support, and preventable suffering will continue to rise. The cost of inaction is measured not only in dollars but in human lives. Care coaching is the most scalable and cost-effective solution available and it is already delivering results.

Judith Feld
CMO at Ontrak Health
Judith Feld MD, PH, MMM, DLFAPA is CMO

Sylvia Rowlands
SVP Clinical Care Services at Ontrak Health
Sylvia Rowlands, EdD is SVP Clinical Care Services

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The Solution to the Mental Health Capacity Crisis is Behavioral Health Care Coaching

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