The strategic use of data in behavioral health systems helps to target resources, implement programs, and evaluate impact. Communicating outcomes of those investments in both human and financial terms – i.e., demonstrating value – is key to continuous systems improvements and meaningful investment.
At the NASHP 2025 conference, Oklahoma and Washington offered state-led examples for combining claims, provider-level behavioral health data, and measures tied to evidence-based interventions (employment, corrections, housing, and education) to tell broader, value-driven stories to policymakers. States looking to identify and communicate the value of their behavioral health investments can take lessons from these approaches, which include:
- prioritizing pragmatic data sharing agreements,
- focused dashboards tied to policy priorities,
- and clear messaging that translates the benefits of behavioral health treatment into metrics that capture progress toward individual health improvement goals, measure the effectiveness of programming, and communicate impact in meaningful terms.
Consider Data Sources and Matching Strategy
The former commissioner of the Oklahoma Department of Mental Health and Substance Abuse Services shared the state’s approach, which has included data-matching across sectors to capture whole person outcomes and financial impact to support value proposition communications.
The state considered an array of data sources, including employment data, substance use trends, homelessness, and criminal justice information as key components in developing a value proposition. Data sharing across state government and data gathered from key external sources informed the value picture – including from the department of human services, employment securities or workforce commissions, homeless services providers, department of corrections, county jails, medical examiner, and other key partners such as Medicaid managed care entities (see call out box).
Oklahoma has used employment earnings data to show wage and tax changes for people engaged in treatment and to compare the cost of behavioral health services to incarceration costs and state per-person costs for homelessness to quantify savings.
Another notable component of Oklahoma’s data approach has been its blended behavioral health system where all claims pass through the Medicaid Management Information System (MMIS). This allows for seamless eligibility checks across Medicaid, block grants, and drug court programs, creating a unified data infrastructure.
Data matching occurs behind the scenes, preserving client privacy within a closed sharing system. Individuals may opt to share data related to services but are not required to do so in order to receive treatment.
Oklahoma’s Key Dashboards
- Treatment Outcomes Dashboard
- Core metrics: employment status, sustained housing, criminal justice contacts, recidivism, emergency department visits, and inpatient behavioral health use.
- Purpose: shows trends such as reductions in homelessness, the number of newly housed individuals, emergency department visits avoided, and dollar figures for costs avoided.
- Substance Use and Functional Outcomes Dashboard
- Core metrics: substance use status at intake and six-month follow-up, engagement in medication for opioid use disorder, education and employment status, housing stability, and criminal justice metrics.
- Purpose: demonstrates program-level change over time and supports federal reporting and provider quality improvement.
- Youth School Impact Dashboard
- Core metrics: absences, suspensions, out-of-home placements by county and program.
- Purpose: links behavioral health services to educational outcomes that resonate with legislators and education partners.
Legislative Engagement and Localized Data
To provide meaningful information to legislators and local officials, Oklahoma has used data matching and cross-sector analysis that reflects the specific counties that decision-makers serve, in addition to public services that may be downstream from behavioral health services. For example, a local look at Oklahoma’s 12.7 percent statewide reduction in unemployment – related to behavioral health interventions – may resonate with legislators focused on economic development in their districts.
Substance use trends are tracked by county in Oklahoma, and a deeper analysis of the state’s drug court participants over five years showed these individuals earned $204 million in wages and paid $6.1 million in taxes when diverted to community supports from incarceration. Compared to incarceration costs, drug courts offer a compelling economic alternative.
Similarly, the state’s housing data showed reductions in homelessness among care-seeking individuals, with cost savings from newly housed clients. Criminal justice data reveals fewer arrests and significant cost avoidance: the Oklahoma Department of Corrections published figures showing that incarcerating individuals with mental illness costs four times more than others.
Value across Health System Touch Points
In Washington, the state is moving behavioral health and primary care integration through Medicaid managed care – focusing on increasing access through workforce and network adequacy approaches and the development of a value proposition and reporting process. Integrated care allows health systems to treat conditions like depression, anxiety disorders, post-traumatic stress disorder, substance use disorders, and co-morbid medical conditions such as heart disease, diabetes, and cancer.
Evolving payment models have spurred increased uptake of integrated models of care along with savings, especially important in safety net health systems. For example, Washington’s Health Homes program for high-cost, high-risk people dually enrolled in Medicare and Medicaid resulted in a return on investment of over $100M, including shared savings awards to the state from Medicare.
The state’s value proposition focuses on ensuring value through four domains: patient experience, quality and clinical outcomes, costs, and provider experience. Decision-makers look at all these dimensions together to determine the value of services. For example, the state measured high levels of patient-rated quality, satisfaction, and access to services. State officials understood the nuances of behavioral health services may not be reflected in traditional quality measures or broader patient experience surveys, so they developed specific behavioral health quality measures and rate increases for behavioral health services. This resulted in higher behavioral health workforce retention and contributed to the state’s goal of prioritizing network adequacy in providing quality care that Washingtonians can readily access.
Washington also relies on a slate of measurement approaches to keep officials and decision-makers informed about the quality of behavioral health services offered, as well as the clinical outcomes for people who receive those services.
These measures, in tandem with cost information, allowed the state to determine that a Medicaid incentive approach (withholding 2 percent of funds that plans could earn back through quality performance) produces improvements in patient health, including behavioral health outcomes. For example, 75 percent of the withhold is contingent on plans’ demonstrating either year-over-year improvement in measure performance or by exceeding the contracted benchmarks for each measure. All plans met those criteria for antidepressant medication management and for substance use treatment rates in 2024.
Washington’s experience shows that quality integration, rate investments, and health-home style care coordination can yield earlier returns on investment. However, they also require sustained commitment to building a workforce and investing in reimbursement rates that reflect the actual cost of care.
Conclusion
A practical, cross-sector approach to determining the value of behavioral health investments communicates intervention successes into measurable, individual, social, and fiscal value. With focused dashboards, pragmatic data agreements, routine follow-up, and strategic messaging, state health officials can secure sustained investments, demonstrate return on investment, and expand whole person care that both improves lives and reduces system costs.
Acknowledgments
NASHP would like to thank Dena Stoner, Carrie Slatton-Hodges, Jason McGill, and Daisy Berbeco for their contributions to this blog. This publication was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U2MOA39467 the National Organizations of State and Local Officials co-operative agreement. This information or content and conclusions are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS, or the U.S. government.
