There is debate around clinician oversight in the evolving landscape of behavioral health tech products, using Pear Therapeutics and Akili, Inc. as examples of shifting business models from prescription to non-prescription. It explores clinicians' push for CMS billing codes for client guidance and remote monitoring, expressing concerns about potential complications and the impact on measurement-based care (MBC). Emphasizing the need for executive leadership, the article calls for efficient systems prioritizing outcomes over billing minutiae, highlighting the clash between fee-for-service (FFS) and value-based care (VBC) approaches. The overarching message stresses the importance of trusting clinically based tech products to function efficiently without unnecessary professional controls.

Here are our key takeaways from the article:

1. Prescription Model Pitfalls: The article highlights the challenges faced by companies like Pear Therapeutics, emphasizing the drawbacks of a prescription-only model for digital therapeutic tools. Pear's bankruptcy after restricting access raises questions about the effectiveness and consumer-friendliness of such approaches.Clinician Compensation Debate: The piece delves into the ongoing debate among clinicians seeking Centers for Medicare & Medicaid Services (CMS) billing codes for guiding clients and remote monitoring. The demand for compensation for Cognitive Behavioral Therapy (CBT) expertise is a focal point, with potential implications for the advancement of measurement-based care (MBC).
2. Executive Leadership in Integration: The article advocates for executive leadership in integrating MBC into outpatient care, citing the system-focused perspective that executives bring. It underscores the need for consumer products to be easily accessible, with outcomes assessed at the level of clinical programs and populations, emphasizing efficiency and accessibility.
3. Efficiency in Value-Based Care (VBC): The clash between fee-for-service (FFS) and value-based care (VBC) approaches is explored, with executives advocating for efficient systems and outcomes-driven care. The shift towards VBC arrangements, focused on efficiency and improved outcomes, challenges the traditional billing mindset of maximizing opportunities.
4. Challenges of Billing Processes: The article raises concerns about billing processes complicating measurement-based care (MBC) clinical monitoring. It argues for the integration of MBC into all outpatient care as a standard process, cautioning against the growth of separate charges and the potential tying of monitoring to specific therapies, such as CBT.
5. Digital Therapeutics in Evolving Healthcare Models: The piece concludes by stressing the mission-critical role of clinically based tech products alongside therapeutic services. It advocates for trusting these products to function efficiently without onerous professional controls, recognizing their potential to address unmet behavioral needs and embed clinical outcomes into everyday care.

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