There was no single metric that told Dr. Mary Affee her practice had outgrown its operations, and that was the frustrating part.
She had built Horizon Integrated Wellness in Cary, N.C., from the ground up as a clinician. The systems holding it together were spreadsheets pulled from the EHR and procedures written as the practice grew. In behavioral health, the margin for that kind of improvisation is thin. Patients are often seen once or twice a week, which leaves little time to resolve an authorization between visits. Miss a snag early and a practice can be six visits into a course of treatment before anyone notices the claims are not being paid, and no clinician wants to pause care over an insurance roadblock.
In this conversation, Dr. Affee walks through how she decided which inefficiencies to address first, how she assessed a technology partner and how she brought a skeptical staff into the decision rather than announcing it to them. Shikhar Khanna of Nanonets Health adds the market view: why behavioral health is the most aggressively managed specialty in the system, and where automation produces defensible savings.
Learnings include:
- How to recognize operational strain when no single metric surfaces it
- Why frequent visits make authorization delays compound faster in behavioral health
- What to prioritize when you cannot address every inefficiency at once
- How to address staff concerns about automation directly