What We Learned at BHB Invest: Proof Is What Gets Paid

Highlights from Hansei’s panel on measurement-based care, clean claims, and network strategy   

In behavioral health, revenue and outcomes are not separate conversations. Every denied claim delays care, and every program that can prove it works has a stronger case for being paid fairly. 

Each year, the Behavioral Health Business (BHB) Invest Conference brings together the people who move the sector: private equity firms, strategic buyers, operators, capital partners, and M&A advisors. Over three days, the conversations go beyond networking to real dealmaking and to where behavioral health goes next. 

On October 29, 2026, Hansei moderated the panel Data That Gets You Paid: Measurement-Based Care, Clean Claims, and Smarter Contracts. Our premise was simple: providers and payers both win when care is measured, and claims are clean. 

A conversation like this only works with the right voices in the room. We were fortunate to be joined by leaders across revenue cycle, compliance, and facility operations: 

• Patrick Dunn, Chief Strategy Officer, Hansei Solutions
• Parker Smith, Co-founder & CEO, Simplifyance
• Rebecca Pirillo, Chief Executive Officer, ERPHealth
• Nick Rogers, Chief Operating Officer, Hansei Solutions 

Together we covered where providers lose revenue, why compliance starts with culture, how to weigh in- and out-of-network strategy, and how outcomes data is reshaping payer relationships.

Here’s what our panelists had to say. 

1. Most denials are process problems, not payer problems 

Hansei’s Chief Operating Officer, Nick Rogers, opened with a reframe: denials and underpayments usually trace back to something that broke inside the provider’s own workflow. Missing clinical documentation, transcription errors, and claims that don’t match a payer’s specific formatting requirements are among the most common culprits. 

The fix starts with the data. Analyzing denials to find root causes lets leadership and clinical teams build prevention plans, not just work the backlog. The payoff shows up in cleaner claims, higher first-pass payment, stronger revenue yield, and steadier cash flow.

One caution: generic payer adjustment codes rarely explain what actually went wrong. Diagnosing the real process failure often takes behavioral health billing expertise that goes beyond reading the remittance.

2. Compliance is downstream of culture

Parker Smith, Co-founder & CEO of Simplifyance, made the case that compliance isn’t a checklist. It’s the result of training, planning, and a culture where accountability and safety are expected. When that foundation is in place, reliable documentation follows.

That readiness matters most when providers go to the table with payers. Organizations pursuing network agreements or value-based care need to show quality and efficacy with measurable data. Anecdotes don’t carry a negotiation.

3. In-network or out? Let your data decide

There’s no universal answer, and we didn’t pretend otherwise. Rebecca, Chief Executive Officer, ERPHealth, walked through the factors she weighs: patient volume, acquisition costs, local competition, workforce considerations, and payer opportunities like centers of excellence and value-based arrangements. Patrick added that regional data, call tracking, and payer fit should all inform the decision. 

Nick framed the trade-off simply. In-network models tend to be more direct and scalable, and they can support patient access and local growth. Out-of-network providers, meanwhile, need strong clinical and outcomes data to negotiate reimbursement that reflects the true cost of their programs.

For out-of-network billing, Parker stressed two things: reliable operations and validated patient-reported outcomes, using tools such as the PHQ-9 and the Brief Addiction Monitor (BAM).

At Hansei, we see the importance of that documentation up close. Our team conducts roughly 14,000 utilization reviews a month, checking whether documentation supports accurate claims, rate negotiations, and reimbursement.

4. Measurement-based care works when it’s built into the workflow

Rebecca described collecting validated measures like the PHQ-9 and GAD-7, along with quality-of-life measures, from pre-admission through post-treatment. The key is making collection patient-friendly and folding it into everyday clinical work, so it informs care instead of adding to staff burden. 

Parker noted that the Joint Commission has required outcomes tracking for about seven years, and failing to track outcomes remains a frequently cited survey finding. Everyone agreed that the specific scale matters less than consistent measurement and genuine patient engagement, all in service of person-centered care.

5. Payers are ready for a broader definition of success

Outcomes data does real work in the revenue cycle. Used well, it can help providers:

• Substantiate medical necessity with objective evidence of patient need
• Justify length of stay, including stays beyond 30 days
• Strengthen appeals when claims are denied
• Build toward value-based care by showing a program’s efficacy and economic value

Payers are also looking beyond abstinence or medication management. Quality of life, employment, community participation, comorbidities, and overall health and wellness are increasingly part of the conversation. One union-payer example showed what that looks like in practice: early screening and peer support connected to provider matching, treatment, and follow-up after discharge.

The open question is how payers will adopt measures beyond self-reported questionnaires. 

Our answer: payers expect providers to bring credible ways to demonstrate effectiveness and prevent recurring high-cost care.

The takeaway: proof is what gets paid

In a room built around dealmaking, one thread held throughout: providers get paid fairly when they can prove the value of the care they deliver. Three outcomes-focused takeaways stood out:

1. Measure what matters. Consistent measurement helps providers understand patient progress and identify where care can improve.
2. Make outcomes useful. Clear, credible results help providers demonstrate the value of their care to payers and referral partners.
3. Connect quality to sustainability. Strong outcomes, clean claims, and thoughtful contracts help providers get paid for the value they deliver.

That’s how programs stay open and patients keep their access to treatment.

Want to know where your revenue is slipping or how your documentation holds up? Let’s talk.