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Where Is This All Going? What Are States Doing/Not Doing To Address Our Mental Health Crisis? Trends In Behavioral Health Financing Models & State Innovation

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Where Is This All Going? What Are States Doing/Not Doing To Address Our Mental Health Crisis?
Trends In Behavioral Health Financing Models & State Innovation

The beginning of this year marked the end of an era in health care financing. Horizontal carve-outs used to be the growing model as physical and behavioral health care was distinctly separated. Now the market is moving quickly to integration. Between 2011 and 2020, the number of state Medicaid programs with integrated behavioral health financing arrangements in Medicaid health plans steadily increased from 25% to 48%.1

As mental health care continues to be a crisis and has been underfunded more states are adopting Medicaid expansion. States also seek to innovate their behavioral health programs to reduce cost and to increase quality and access to treatment.

In this webinar, we are going to review the status of behavioral health financing at the state level. From there we will discuss some state innovations we have seen and will be of interest to anyone that would like to see the future of the state behavioral health landscape.

Reference:
1 State Medicaid Behavioral Health Carve-Outs: The OPEN MINDS 2020 Annual Update. 2020, January). Retrieved May 07, 2021, from https://openminds.com/wp-content/uploads/OM_MarketIntelReport_Medicaid_BHCarveout_10920.pdf.

Speakers:

Richard Louis, III, Vice President, OPEN MINDS*

Richard Louis, III has extensive experience as a behavioral health administrator, business development specialist and innovator of new service lines.  Before joining OPEN MINDS, Mr. Louis was the Director of Development For – Behavior & Addiction Medicine at Southern California Healthcare Systems Inc of Prospect Medical. He was involved with projects focused on health care integration, new service lines, and health plan contract development.  In that role, he pioneered the development of a series of innovative and profitable integrated behavioral health treatment and population health management solutions that target high cost and complex behavioral health populations.

Mr. Louis was also the Executive Director of Strategic Development and Planning at Pathways – Molina Healthcare, the division of the health plan operating behavioral health services in 23 states. In this role, Mr. Louis developed and launched population health management program strategies that included in-community care management and in-home coordinated care services to reduce hospital re admissions, emergency department (ED) visits and improve HEDIS scores for national health plans and managed care organizations.

Mr. Louis graduated with a Bachelor of Arts in psychology from Whittier College and is a Police Academy Graduate from Rio Hondo College in Whittier, California.

Deb Adler, Advisory Board, OPEN MINDS*

Deb Adler brings more than 20 years of experience in executive health care roles, serving in a variety of capacities including network executive, quality management executive, and chief operating officer, to the OPEN MINDS team.

Her consultant work with OPEN MINDS spans a broad range of customers (provider organizations, payors, and government programs) and topics, including collaborative care models/medical behavioral integration, provider network functions– contracting, network designs/tiering, recruitment, telehealth network implementation, and strategic planning. In addition, Ms. Adler has a special interest in helping technology-enabled providers in “go-to-market” strategies and streamlining network functions.

Since entering the managed behavioral health care field, she has become an industry-recognized leader in value-based contracting and alternative payment models. An innovator known for her ability to execute results, she has facilitated network designs and benefit plan approaches that achieve both quality outcomes and healthcare cost savings.

Ms. Adler has served as the Senior Vice President of Network and Quality at Talkspace. Before that she was Senior Vice President of Network Strategy for Optum (now UnitedHealth Group) where she was responsible for behavioral health network development, contracting, and strategy for over 185,000 providers.

Ms. Adler received her Master’s degree in educational psychology and evaluation from the Catholic University of America and is a Certified Professional in Health Care Quality (CPHQ).

Moderator:

Hiten Patadia, PharmD, Managed Market Liaison, Otsuka Pharmaceutical Development & Commercialization, Inc.*

Hiten Patadia, PharmD is a Managed Markets Liaison at Otsuka, based out of San Diego, California.  Dr Patadia earned his PharmD from Albany College of Pharmacy and Health Sciences in Albany, New York.  Prior to joining Otsuka, Dr Patadia worked for a large Pharmacy Benefit Manager where he managed prescription benefits for employer groups.  He is an expert in the commercial insurance market.  Dr Patadia is responsible for providing clinical and economic information to payers located in Alaska, California, Hawaii, Nevada, Oregon.

Featuring

  • Richard Louis, III,

    Vice President, OPEN MINDS

  • Deb Adler,

    Advisory Board, OPEN MINDS

  • Hiten Patadia, PharmD (OPDC)

    Managed Market Liaison

Mr. Louis and Ms. Adler are paid consultants of Otsuka Pharmaceutical Development & Commercialization, Inc. (OPDC)
Dr. Patadia is an employee of Otsuka Pharmaceutical Development & Commercialization, Inc.

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