We're proud to share that TPN.health CEO and co-founder Trevor Colhoun and TPN.match President Kolby Nance, L.M.H.C., were featured in Medical Economics on August 13, 2026 with a commentary titled "More than a staffing issue: The behavioral health crisis is an operations challenge." Their argument: the clinician shortage is real, but it isn't the only reason mental health referrals go nowhere.
The gap between a positive screen and a first session
Primary care physicians and OB-GYNs have become the default front door for behavioral health, and up to one third of clinicians now report that more than 20% of their patients need mental or behavioral health treatment during visits. But identifying a condition and getting the patient into treatment are two different things — and Colhoun and Nance argue the gap between them isn't clinical. It's operational.
Three frictions do most of the damage:
Credentialing. Approval to bill a commercial payer takes 30 to 45 days at best, and 90 days or longer for Medicare and Medicaid. Backlogs for behavioral health and telehealth providers have risen roughly 22% in a single year. Throughout that window, a fully licensed, willing clinician can't see an insured patient.
Billing. Reimbursement rules vary by payer and code, and the overhead falls hardest on solo and small-group practices — a major reason so many clinicians stay out-of-network entirely.
Ghost networks. A 2025 federal investigation found 55% of behavioral health providers in sampled Medicare Advantage directories were inactive. A 2023 Senate Finance Committee secret shopper study found 80% of mental health listings inaccurate or unavailable.
Why back-office friction becomes patient harm
A physician who identifies a mental health condition and hands a patient a referral list is, in reality, simply turning the individual over to a scavenger hunt.
Every dead end adds delay, and delay has consequences: worsened chronic disease control, avoidable emergency visits, and crises that could have been caught earlier. The stakes are highest in perinatal mental health, substance use disorder and neurodevelopmental conditions, where the window for effective intervention is narrow.
Fixing it means centralized credentialing, standardized billing rules, directories that reflect real-time availability, and interoperability between physical and behavioral health records. The test Colhoun and Nance offer for any investment a practice is weighing: does this actually shorten the distance between a positive screen and a patient in treatment?