For decades, community mental health providers have received funding based largely on activity - the number of sessions delivered, hours logged, or programs completed. While this approach helped track service volume, it said little about whether participants actually achieved meaningful outcomes.
Today, that’s no longer enough. Funders and tender committees increasingly prioritize outcome-based funding, where payment is linked not only to what services are provided but also to the impact they deliver. This shift reflects broader trends across healthcare: moving away from measuring inputs and outputs, and toward measuring results.
For community mental health providers, this change brings both opportunity and challenge. Those able to evidence strong outcomes will thrive. Those relying on outdated engagement models risk losing competitiveness.
At the heart of this shift lies one critical factor: participant engagement.
Engagement is the foundation of all mental health progress. Participants who consistently attend appointments, complete program activities, and stay connected between sessions are more likely to achieve their goals. Conversely, disengagement leads to missed appointments, incomplete programs, and stalled progress.
Outcome-based funding magnifies the importance of engagement because:
Put simply, services cannot deliver outcomes without sustained engagement. Yet many organizations still lack the strategies and tools to keep participants connected throughout their journey.
Traditional engagement approaches often focus narrowly on sessions themselves. Providers assume that if a participant attends, they are engaged. But engagement is more complex. It spans every touchpoint - from initial intake through ongoing communication to post-program follow-up.
Without modern engagement strategies, common gaps appear:
These gaps are not just operational inefficiencies. Under outcome-based funding models, they directly jeopardize financial sustainability.
In traditional funding models, disengagement was frustrating but often survivable. A participant dropping out meant wasted effort but did not necessarily affect revenue.
Under outcome-based funding, disengagement translates to lost outcomes - and therefore lost funding. Programs with high dropout rates or weak participant progress will struggle to demonstrate value. Even if staff work tirelessly, the inability to evidence outcomes will weaken credibility in tenders and contract renewals.
This raises the stakes dramatically. Engagement is no longer just a clinical concern; it is a business-critical function that underpins organizational sustainability.
While challenging, the shift to outcome-based funding creates opportunities for providers who invest in participant engagement. By demonstrating that participants not only enter programs but also achieve results, organizations can position themselves as trusted, future-ready partners to funders.
Engagement becomes a differentiator in tenders. A provider that can evidence high retention rates, consistent progress tracking, and strong participant satisfaction will stand out from competitors. In a crowded funding environment, this edge can make the difference between winning and losing a contract.
Improving engagement requires more than reminders or incentives. It requires a holistic, participant-centered approach that combines strategy, systems, and support. Effective engagement strategies typically include:
1. Personalized pathways:
Tailoring digital resources, reminders, and goals to reflect each participant’s needs.
2. Continuous connection:
Maintaining contact between sessions with messaging, nudges, and accessible digital resources.
3. Hybrid flexibility:
Offering both in-person and digital participation options to reduce barriers.
4. Accessible design:
Ensuring tools are inclusive for participants with diverse literacy, language, and ability levels.
5. Feedback loops:
Gathering real-time insights so participants feel heard and services can adapt.
6. Data-driven monitoring:
Using secure systems to track engagement trends and intervene early when participation drops.
These strategies transform engagement from an afterthought into an embedded part of service delivery.
Modern engagement strategies depend heavily on digital infrastructure. Without it, personalization, continuous contact, and real-time monitoring become nearly impossible.
For example:
By contrast, organizations relying solely on paper forms, static handouts, or phone calls will struggle to sustain engagement at scale.
Outcome-based funding also places a spotlight on equity. Funders want assurance that services reach and support diverse populations, including those traditionally excluded from care. Engagement strategies must therefore account for barriers such as geography, mobility, language, and digital literacy.
Digital tools play a crucial role in leveling the field. Features like captioned video, multilingual resources, text-to-speech functionality, and remote participation options expand access for participants who might otherwise disengage.
When engagement strategies prioritize equity, they not only improve outcomes but also strengthen competitiveness in outcome-based funding models.
To illustrate the impact, consider two scenarios.
A participant enrolls in a program, attends two sessions, and then misses the next three. Staff call once but can’t reach them. The participant feels disconnected, and eventually drops out. When reporting is due, the provider has no evidence of outcomes. Funding is at risk.
The same participant receives app reminders before sessions and a supportive message afterward. They complete a short reflection in an app between sessions and access personalized resources aligned to their goals. Staff see their progress on a dashboard and intervene quickly when engagement dips. The participant feels supported, completes the program, and reports positive outcomes. Funding is secured.
The difference is not subtle - it’s the difference between losing and sustaining funding.
Some providers hesitate to overhaul engagement strategies, citing cost, complexity, or staff readiness. But standing still is increasingly risky. As more organizations embrace outcome-based models, those without strong engagement systems will stand out for the wrong reasons.
The risks include:
In outcome-based funding environments, doing nothing is no longer an option.
The path forward is not about quick fixes but about building sustainable, scalable engagement systems. Providers can start with manageable steps:
By taking incremental steps, organizations can move toward outcome-based readiness without overwhelming staff or budgets.
Outcome-based funding is reshaping the landscape of community mental health. It raises the bar for accountability but also creates opportunities for providers who can demonstrate strong engagement strategies.
At its core, this shift is about alignment: funding tied to meaningful outcomes, achieved through engaged participants. Providers that invest in participant-centered engagement systems will not only secure funding but also deliver better care. Those that resist risk losing both.
The message is clear: to succeed in outcome-based funding, you must succeed in engagement.
Wellifiy partners with community mental health providers to strengthen participant engagement in the era of outcome-based funding. Founded by Clinical Psychologist Dr Noam Dishon (PhD Clinical Psychology), Wellifiy provides a white-labelled platform that unifies messaging, appointments, content delivery, and participant tasks into one secure environment. By embedding engagement into digital workflows, Wellifiy helps providers improve outcomes, reduce staff burden, and demonstrate impact to funders.
