An emphasis on measurement-based care, accountability and defending value are the trends that will transcend across mental health, substance use and autism care in 2026 amid forthcoming intensified scrutiny and market pressures.
Payer demands and the federal government’s crackdown on waste, fraud and abuse will likely drive providers to focus more on proving value via measurements and data, as well as on cost containment, industry insiders told Behavioral Health Business.
With the influx of AI tools that can assist with data tracking, trend analysis and efficiency, providers will also face the challenge of vetting and adopting new technologies while weighing their liabilities. Across the board, practitioners say AI should not replace human care but enhance it. It’s also one of the areas organizations in every sector of behavioral health told BHB they plan to prioritize investments in for 2026.
The trick will be balancing investments in new technologies and innovative care, while navigating how to show measurable impact and defining the metrics that matter most to both payers and investors.
Lacking a crystal ball the industry can stare into for insights into 2026, Behavioral Health Business connected with leaders across 21 behavioral health organizations to paint a picture of what may lie ahead.
In mental health, executives predict a pivot away from a race to scale and toward a renewed focus on clinical credibility, where differentiation and accountability will become a new competitive edge. AI adoption and clinical specialization will play supporting roles as companies work to improve care, cut costs and streamline workflows to help practitioners meet payer expectations. The industry’s enduring quest to define what “quality” is will likely garner new discussion, too, as novel tools for data analysis and measurement-based care flood the marketplace.
Across the autism therapy sector, there is a strong consensus about the challenges the next year holds for operators, from increased payer scrutiny, workforce shortages to rising demands for compliance, reporting and infrastructure.
Providers also anticipate further movement away from the mainstay autism therapy, applied behavioral analysis (ABA) and commitment to multidisciplinary care models. Clinical trends also point to lower authorized dosages and tightened criteria for medical necessity amid expected audits. Insiders across the autism therapy market expect a spike in consolidation throughout 2026 as companies adapt to intensified scrutiny and industry demands.
SUD care in 2026 may be characterized by a push to clearly demonstrate outcomes and a return on investment for buyers, since the market in 2025 experienced lackluster performance. Providers seem to agree that this push will also drive a focus on scalability and sustainability while balancing investments in innovation and technology to propel them forward.
The SUD industry may be at a turning point to reframe addiction as a chronic, medically complex condition rather than episodic. Decreasing stigma as the field continues to see growing acceptance for medication-assisted treatments (MAT) and integrated care models may also build patient trust and cue innovation, even amid political and funding uncertainties ahead in 2026.
Collectively, industry insiders seem to anticipate a year when accountability will be driven by measurable outcomes and ROI. Payers, investors and policy headwinds will demand providers be ready to prove their outcomes and demonstrate accountability with data and results. Regardless of which side of the behavioral health industry operators are on, they should get ready for a year of proving themselves to all stakeholders.
BHB asked providers what they anticipated being the No. 1 factor shaping the behavioral health market in 2026 and why.
The following responses have been lightly edited for length and clarity.
Specialization and differentiated models will shape mental health in 2026
“I believe the integration of interventional psychiatry into standard treatment pathways may be a defining shift in 2026. TMS and Spravato are moving beyond specialty settings into standard-of-care territory for treatment-resistant depression, driven by strong real-world evidence of durable remission and reduced hospitalizations.
This matters because patients with difficult-to-treat depression often experience multiple prolonged episodes across their lifespan, and we know early identification of treatment resistance and prompt access to differentiated interventions gives them the best chance of recovery. I expect payers will be pressured to move beyond multiple ineffective medication trials that fail to deliver timely improvements in patient outcomes, as earlier use of interventional treatments lowers the total cost of care.
Beyond simply offering these innovative treatments, the next step could be integrating TMS and Spravato with psychotherapy and medication management to support sustained recovery and help patients maintain remission. I believe organizations that build this integrated infrastructure now may lead as the market shifts from step-and-fail protocols to outcome-driven treatment pathways.”
—Dr. Rachel Dalthorp, executive medical director of specialty services, LifeStance Health
“Continued progress in clinical excellence will shape behavioral health in the new year. By focusing on a higher impact of care, we’ll see true measurable results such as reduced emergency room visits, shorter inpatient stays, and a reduced need for higher levels of care.
There will be greater continuity of care across the board, meaning people are connected with the right care earlier in their journey, and facilitated with safe, seamless transitions up or downstream. The providers who can consistently deliver high-impact, evidence-based care and connect people to the right level of support at the right time will drive the next era of healthcare integration.”
–Dr. Dan Frogel, CEO, Thriveworks
“In 2026, ever-evolving client expectations will continue to shape our industry. People want care that is on-demand but also personalized and deeply human. Culturally, people are more in tune with their mental health needs, and the benefits it can provide, but want support that is tailored to their unique circumstances, preferences and lifestyle.
Of course, AI will play a meaningful role in connecting clients to the right care at the right time, but this should be done in a support capacity – not by replacing clinicians. Ultimately, highly personalized, evidence-based and human-centric solutions are going to be the gold star standard for quality. Exciting and shiny new tech has its place, but in thoughtful integration that elevates quality rather than competes with it.”
–Kabir Daya, chief digital officer and chief marketing officer, Thriveworks
“Specialization will define the behavioral health landscape in 2026. We’re moving away from broad, undifferentiated models toward population and condition-specific expertise, including women’s health, heart disease, diabetes and obesity-behavioral health intersections.
At the same time, value-based care will become unavoidable. Payers have a growing imperative to demonstrate the outcomes, and risk and cost reduction driven by their behavioral health partners. The combination of specialization and accountable care models will truly reshape how the industry organizes itself.”
–Jenny Welling-Palmer, chief strategy officer, Thriveworks
“Without a doubt, the most meaningful force shaping BHB markets in 2026 will be quality. And I don’t mean collecting PHQ-9s, GAD-7s, etc., but true, high-quality care. When we look at the communities we serve, a meaningful percentage of Americans engaging in behavioral health services have tried some form of therapy before.
Clients are demanding a higher-quality experience, covering everything from the initial interaction to the logistical experience with the service to the care itself. We must work as an industry to elevate the standard of care in 2026 if we hope to make a meaningful impact on the health of America.”
–Michael Midgette, chief growth officer, Thriveworks
‘Cookie-cutter approaches’ to autism services ‘will not fly’ in 2026
“The increase in the number of children diagnosed with autism spectrum disorder means more families will continue to seek ABA therapy, the gold standard for autism treatment, for their children.
We need to streamline care delivery so kids can quickly get the help they need, and, at the same time, we must ensure a seamless experience for our families. Enhancing our support of families from their first interaction with our centers and through each step of their child’s care is a top priority for Acorn Health in the years ahead.”
–Mony Iyer, president and CEO, Acorn Health
“The No. 1 factor shaping the autism therapy market in 2026 will be reimbursement pressure paired with workforce shortages, especially in rural and mid-sized communities. Providers are being pushed to deliver higher-quality care with increasing regulatory expectations, while still navigating stagnant or inconsistent payer rates. This dynamic is forcing organizations to rethink how they recruit, train, and retain clinicians across disciplines — not just ABA, but speech and occupational therapy as well.
In 2026, the winners will be the organizations that invest heavily in clinician support systems, technology efficiency and sustainable caseload structures. Ultimately, the industry will be defined by how well providers balance quality, access and financial viability in a rapidly changing landscape.”
–Eric Plunkett, board chair, Axis Therapy Centers
“I anticipate that the primary force shaping the BHB market in 2026 will be the heightened requirement for organizations to clearly substantiate their value. The ongoing tension between network inadequacy and payers’ concerns regarding over-utilization is creating conditions for a genuine “survival of the fittest.”
While payers recognize the necessity of these services and their obligation to fund them, they are increasingly focused on ensuring that their investments generate measurable, meaningful outcomes. Consequently, providers will be expected to present robust, transparent performance metrics that objectively demonstrate their effectiveness and value in order to maintain their position within the market.”
–Leonard Jeger, CEO, BrightBridge ABA
“In 2026, the market will be shaped most by our collective willingness to define and adopt shared outcome standards. With funding pressures increasing, there is a growing temptation to make decisions based solely on cost. But cost alone doesn’t protect children, families or long-term system sustainability.
When we align on what ‘good outcomes’ look like, and measure them consistently, we create a win-win-win environment. Families receive care that is proven to help. Providers who invest in strong care models and quality oversight are recognized for the value they deliver. Payers can make smarter, more sustainable decisions that reduce unnecessary spend, while improving results.
The future of behavioral health depends on moving past cost-based comparisons and toward outcome-based accountability.”
–Timothy Yeager, chief clinical officer, Centria Autism
“The push for defined, measurable outcomes in ABA will only intensify as value-based care contracts gain traction and expectations increase for standards and measurement for what “good” looks like. Tying fair and appropriate payment to real outcomes will help move the field forward.
At the same time, payers hold significant influence and are responding to rising demand with policies that restrict treatment frequency, narrow definitions of medical necessity, and shrink provider networks in an effort to curb coverage.
Ongoing education and direct, data-driven conversations with private insurers and state Medicaid programs will be critical to ensure timely and reasonable payment for medically necessary ABA and to shape the ABA market for years to come.
–David Mikula, CEO, Inner Circle Autism Network
“A big factor shaping ABA services in 2026 will be transparency in measurable clinical quality, standardization in outcome measures, and metrics that demonstrate impact.
It is not enough to say that a company is high-quality. Payers and regulators are demanding evidence of efficacy, and organizations that cannot show consistent progress and value will face growing pressure.
At the same time, continued workforce shortages at the BCBA and technician levels will require providers to invest in sustainable training, technology, and structured supervision models to maintain quality while scaling. Organizations that can demonstrate a shift towards measurable outcomes will be more likely to succeed.”
–Ivy Chong, chief clinical officer, Little Leaves Behavioral Service
“There is an ongoing shift in Autism Care from focusing on access to focusing on quality and “cost-effective” care. Payers are under tremendous stress and this is trickling down to the providers as well. Some of this is due to the utilization trends elsewhere, but utilization in behavioral health, and autism in particular, is becoming a top priority for plans.
Providers will need to prove not only that they can deliver timely care to a plan’s members, but also that the care is both high-quality and cost-effective. Cookie-cutter approaches are not going to fly going forward.”
–Dr. Daniel Spiegel, senior vice president of growth and development, Soar Autism Center
“The biggest factor shaping the market in 2026 will be heightened cost scrutiny from payers, which will push providers toward more efficient, integrated care models. Rather than relying on legacy 40-hour per week ABA-only models, the market will shift toward holistic, multidisciplinary approaches delivered at clinically appropriate, cost-effective dosages.
At Westside, we’ve already seen this trend accelerate, and our ability to demonstrate responsible stewardship of care has positioned us well with payers. Providers will also need to automate clinical outcome aggregation as expectations for standardized, provable results continue to rise.
Taken together – higher compliance demands, lower authorized dosages, and the need for data transparency – these pressures will likely accelerate industry consolidation.”
–Mark Cassidy, CEO, Westside Children’s Therapy
Value will remain the ‘north star’ of SUD industry progress in 2026
“In 2026, the single biggest force shaping the field will be the shift toward a new standard of care, one that recognizes addiction as a dynamic, medically complex brain-body condition that demands continuous, adaptive support.
The drug landscape will keep accelerating, but so will our ability to respond through better medical integration, smarter use of data, and more personalized care pathways. Technology, from wearable-based physiology monitoring to AI-supported clinical decision-making, will move from the edges of care to its center.
What will define 2026 is the transition from treating episodes to managing a chronic condition with the same precision we expect in cardiology or oncology. Providers who embrace this vision, blending medicine, measurement, and meaningful human connection, will set the national trajectory for the future of addiction care.”
–Dr. Lawrence Weinstein, medical director, American Addiction Centers
“As we look toward the future of SUD care in America, one of the industry’s biggest questions has shifted firmly from “Can virtual care work?” to “Can virtual care scale?”
For me, the answer is a resounding yes, but not without its challenges. Over the next year, I see the need for scale ushering us into our next phase as an industry – one where success means moving from simply being care providers to being care ecosystems.
From health systems to emergency departments to prisons and jails, there are millions of Americans who could be connected seamlessly with the gold standard in SUD care. Today, they are often left to slip through the cracks. Winning the battle against substance use and opioid use disorder in this country means plugging those gaps once and for all. Being able to do that, and do it consistently and at scale, is what will define success over the next year.
The OUD and SUD industry will also have to look beyond programs, payers, or organizations heavily reliant on federal funding. We’ll have to continue to develop creative public-private collaborations at the local and state levels to keep making progress.”
–Ankit Gupta, founder and CEO, Bicycle Health
“Payers who adopt innovative approaches, like scalable tech-enabled care with measurable outcomes, will win in an increasingly high-pressure environment. To be effective partners, providers need to prove quality and the total cost of care impact on both short and long-term time horizons.
With continued stress on safety net systems, we need to build models that allow clinicians to operate at the top of their expertise, expand support staff like Peers, and offer sustainable work, so providers can deliver high-quality care without burnout.
In addiction medicine, effective AI implementation will not replace human connection; instead, the most successful providers will use it to create more space for trusted therapeutic relationships. The best providers will integrate new technology into tedious administrative workflows like revenue cycle management and claims processing, and advance the field with intelligent care models that tailor care to individual needs.”
–Stephanie Strong, co-founder and CEO, Boulder Care
“I think the biggest factor in the coming year focuses on the ability of SUD providers to leverage technology in balance with human touch and interaction to create high-quality treatment experiences that meet the surging demand for patient access to care.
Providers who master this balance will leap past the ones who do not in terms of care quality and employee experience/satisfaction. “
–Jeremy Klemanski, president and CEO, Gateway Foundation
“AI and technology will be the biggest drivers in 2026. The challenge is making sure they enhance care rather than replace it. In behavioral health, there’s a risk that technology becomes a substitute for human connection. We need to use innovation to reduce administrative burden and personalize care, so clinicians can spend more time building relationships and preparing for shifts in how care is delivered.”
–Dr. Joseph Lee, president and CEO, Hazelden Betty Ford Foundation
“The key issues in 2025, continuing in 2026 that will impact treatment providers are:
Commercial Insurance reimbursement competition and rates and the democratizing of rates for fair market competition and equal access to care. This plays into the rising costs to the consumer in both private/commercial and public/Medicare/Medicaid insurance.
Treatment Program differentiation, communications, marketing strategies and industry reputation.
All of which ties to what the quality of care actually is which requires the continued evolution of the SUD treatment clinical model from its origins as social care to a medical model within U.S. Healthcare. A key component of the model of care is the emphasis on integrated care, which goes beyond co-occurring care. A paradoxical trend involves mainstream medical integrating behavioral health and behavioral health integrating mainstream medical. The latter should be the most cost-effective, where behavioral health can provide or braid care into the behavioral health model.
Advances will be made in pharmacology, both for harm reduction and long-term recovery. The debate over the entry of MAT into SUD treatment should be long over. Now, we have the matter of scientifically validating pharma interventions, including replacement therapies, the study of psychedelics and off-label prescribing of drugs like GLP-1s in particular.
Developing technologically advanced operations, including AI, while keeping a person-focused workplace.”
–Marvin Ventrell, CEO, National Association of Addiction Treatment Professionals
“Building trusted relationships between families and clinical teams will be the defining factor. Trust takes time, and it’s foundational for effective treatment.
Alongside that, we must continue to invest in building confidence among providers to treat and address SUD needs.
Empowering clinicians with the right tools, training, and support ensures they feel prepared to deliver comprehensive care. This combination — trusted relationships and confident providers — will drive meaningful progress in the year ahead.”
–Kelsie Brandt, chief clinical officer, Nest Health
“The number of Americans struggling with alcohol use disorder (AUD) will continue to fall after declining from 29.7 million in 2021 to 27.9 million in 2024. Shifting generational attitudes, better health information, and more accessible treatment options are all important contributors.
The percentage of people with AUD prescribed a medication to help them drink less or quit will continue to increase after growing from 1.9% in 2023 to 2.5% in 2024.”
–Jonathan Hunt-Glassman, founder and CEO, Oar Health
“I see two areas of innovation shaping the SUD market this coming year. First, AI-native clinical models will begin transforming care delivery, yielding more sophisticated and data-informed triage, increased capacity and clinician productivity, and deeper personalization.
Second, evidence has further amassed for the clinical efficacy of contingency management in the treatment of substance use disorder this past year, with the first study of its kind to demonstrate its impact on mortality, with a 41% reduction in mortality risk among those who received this intervention relative to those who did not.
Though reimbursement barriers, stigma and operational complexity have previously hindered the scaling of contingency management, several recent policy wins coupled with the recommendation of use of contingency management in the National Drug Control Strategy have positioned this approach for wider adoption.
Looking to 2026, I anticipate contingency management becoming a central component of high-quality SUD care, given that digital delivery is feasible at scale, enabling widened access to life-saving treatment that is gaining broader acceptance from buyers, clinical thought leaders and policymakers.”
–Dr. Suzette Glasner, chief scientific officer, Pelago
“The focus of the SUD treatment in 2026 is going to continue to be on open access decreasing stigma, and creating treatment opportunities for patients who previously did not have the ability to connect to care.
As we continue to expand the use of safe medication options such as buprenorphine and naltrexone through telehealth, this will start a wave of acceptance of these as treatment options in areas previously barren of SUD support.
Specifically, the improved ability to acquire insurance-based care will afford the entire country’s improvements because of the reach to previously unattainable areas.”
–Dr. Amy Swift, deputy chief medical officer, Silver Hill Hospital
“Value will remain the north star. The companies that measure what truly matters most to patients and have the courage to organize their product and service delivery around that will ultimately win the day.”
–Dr. Justin Coffey, chief medical officer, Workit Health