Behavioral health — Wylie Performance Partners

INDUSTRIES · BEHAVIORAL HEALTH

The service is delivered where people are.
The cost structure reflects that.

We analyzed the reported spending of 501 community mental health and behavioral health organizations. The spending pattern here is unlike any other part of healthcare because much of the work happens in homes, schools, shelters and vehicles rather than in a building the organization owns.

THE PATTERN

Travel is the most variable category here,
and in this sector it is not overhead.

More than half of organizations report travel spending well above the peer median — among the highest shares we have seen in any category. In most industries that would read as an administrative line worth questioning. Here it usually reads as service delivery.

Mobile crisis response, assertive community treatment, school-based services, home visits and client transport all put staff on the road as a condition of the model. An organization running more of its service in the community will report more travel, and that may be exactly what its contracts require.

So the question is not whether the number is high. It is whether the arrangements underneath it — fleet, fuel, mileage reimbursement, vehicle insurance and maintenance — have been looked at as a single category rather than as five separate line items in five different program budgets.

CATEGORY	SHARE WITH FILED SPEND ABOVE 1.5× PEER MEDIAN
Travel & mileage		52%
IT hardware & services		45%
Insurance		39%
Office supplies		39%
Telecom		36%
Professional services		32%
Maintenance		28%

Method note. Share of organizations whose reported spend exceeds 1.5× the peer median. Peer groups of 50 or more, same reporting period. Above median is not overspending — it is a reason to ask why.

What makes this sector structurally different

Much of the revenue side is constrained

Medicaid reimbursement and state or county contract rates shape a substantial portion of the top line. Those rates do not move simply because operating costs increase.

Protecting the workforce matters more than cutting the budget

The objective is not to reduce resources around care. It is to recover unnecessary cost in the categories surrounding care so more dollars remain available for the workforce and the mission.

Programs are funded separately

A vehicle fleet, a phone plan or an insurance policy may be split across several contracts and grants, making it difficult for any one person to see the whole of a category.

Liability coverage has repriced

Nearly four in ten organizations report insurance above the peer median. Coverage has hardened, and renewals may have been accepted rather than tested.

Where a conversation usually starts

Fleet, fuel and mileage

Vehicle acquisition and financing, fuel purchasing, maintenance, mileage reimbursement policy and vehicle insurance — usually bought separately and rarely reviewed together.

Insurance and liability

Professional liability, auto fleet, property and workers' compensation. Frequently placed through the same broker for many years.

Telecom and mobile

A mobile workforce means devices, data plans and connectivity at every site. Plans often accumulate as headcount changes rather than being resized.

WHERE WE WOULD NOT START

Anything that touches direct care staffing or clinical capacity. The pressure in this sector is on the workforce, and a cost exercise that makes that harder is not worth running. We work the categories around the service, not the service.

WHAT THE WIDER RESEARCH REPORTS

No published benchmark covers community behavioral health.

We are not aware of published indirect-spend benchmarking specific to community behavioral health. The figures below are broader.

Indirect spend in healthcare is put at 60% to 80% of total company spend.

Efficio, 2026

The de minimis indirect cost rate allowed on federal grants was raised from 10% to 15% in 2024.

US Office of Management and Budget

62% of respondents across sectors named budget pressure as their leading concern.

RS Indirect Procurement Report, 2025

These figures describe ranges observed across an industry, drawn from samples that may or may not resemble your organization. We publish the source and the sample size for each one because a range is useful for orientation even when it cannot be a conclusion. None of them describe you. The analysis above comes from the reported figures of 501 organizations in this sector.

CONTINUE

See how cost recovery works

The four stages, the categories, and the fee model.

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Other sectors

How the pattern differs elsewhere, and why.

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The research behind this

What we publish, and what we are building next.

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A 45-minute working session.
Your numbers. Your operating model. No assumptions.

We will talk through fleet, insurance and telecom as single categories rather than as programme line items, and leave anything touching direct care alone.

No fee for the conversation, and no cost unless verified value is recovered.

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