The Future of Financing Mental Health and Addiction Services
For chronic illnesses that need to be managed over time, not solely in acute instances, aligning the payment incentives to overall health and wellness re-orients care away from a fee-for-service volume-based focus. The vast majority of this in the market today is driven by CMS through the Medicare Accountable Care Programs, however, commercial insurers have now increasingly moved toward value-based primary care offerings and deploying other condition-specific episodes of care.Emerging promising examples beginning in behavioral health – A number of new models have recently emerged including the Certified Community Behavioral Health Clinic (CCBHC) model for non-profit mental health and addiction services, the P-COAT model from ASAM for Opioid Use Disorder episodes, and the Addiction Recovery Model Home - Alternative Payment Model (ARMH-APM) for integrated Substance Use Disorder care. Each model provides increased flexibility of payment to the provider in some kind of bundle-based or episode-of-care framework that packages together a more comprehensive set of services along the continuum and frees up the provider to care for an individual and their needs in flexible and independent ways versus the rigidity of independent CPT billing codes.
- Attendees will learn from payers and providers what their vision for the transition to value looks like in the mental health and addiction
- The panel will discuss the core challenges that need to be overcome operationally and technologically.
- How these services can and perhaps should be purchased and financed in the future
- A review of emerging models and pilots taking shape across the country
Erin Booker, LPC, is vice president of Behavioral Health and Social Care Integration at ChristianaCare. She joined ChristianaCare in 2015. In this role, Booker oversees the Office of Community Health, Behavioral Health Service Line, Complex Care and Community Medicine as well as the Acute Medicine Service Line. In these areas she is responsible for developing strategic community partnerships, creating and implementing a portfolio of innovative programs and evidence-based initiatives to advance the health of the community, and overseeing ChristianaCare community benefit activities. Within her current role she is also responsible for the implementation of the regional Behavioral Health and Community Medicine Strategies as well as the operations of the Acute Medicine service line Within these areas she works to implement population health strategies to reduce the incidence of disease and improve health outcomes, advance prevention, respond to ChristianaCare Community Health Needs Assessment priority areas, and address the social determinants of health and health disparities.
Booker served as a ChristianaCare corporate director of Behavioral Health since June 2015, maintaining the operational needs of the Behavioral Health service line, developing and implementing new programming, and creating annual goals and strategies. She also played a vital role in the operation of ChristianaCare’s nationally recognized Project Engage, has been a key stakeholder in the development of Community SOS, an innovative program designed to address substance use disorder, and has been responsible for hospital operations for the Neuroscience service line. Before coming to ChristianaCare, Booker was executive director at the Kirkbride Center in Philadelphia where she was responsible for maintaining the organizational and operational needs of that 223 bed acute psychiatric/drug and alcohol rehabilitation hospital.
Eric Bailly is currently a Business Solutions Director at Anthem, Inc. In his 14th year at Anthem, Eric’s role is focused on the enterprise substance use disorder strategy, with recent emphasis on the enterprise opioid strategy. This work comes with an opportunity to shape Anthem's organizational response when it comes to provider partnerships, vendor relationships and the provision of subject matter expertise tied to product development, government relations and corporate public policy.
Eric earned a Bachelors Degree in Psychology from Concordia College in Moorhead, MN in 1993, and a Masters Degree in Counseling Psychology from the University of Colorado at Denver in 1996. Eric is a Licensed Professional Counselor in the states of ND and CO and is a Licensed Alcohol and Drug Counselor in the state of MN. Eric has worked as a behavioral health clinician in several settings including Outpatient Substance Use Disorder treatment services at both Kaiser Permanente and the Jefferson County Department of Health and Environment, both in the Denver, CO metro area.
Eric is also an adjunct professor at the Concordia College, School of Healthcare Professions where he teaches Health Information Systems to undergraduate students pursuing degrees in healthcare and healthcare administration. Additionally, Eric serves on a variety of boards and committees tied to organizations who are committed to improving the health and wellbeing of those who live with mental health and substance use issues.
Andy Kelly is the Vice President, Provider Enablement at Optum Behavioral Health Solutions, part of UnitedHealth Group. He leads the development, implementation and operation of value based programs across health plans and payers focusing on innovating for the future. His background includes a communications degree from the University of Dayton, a healthcare MBA from the University of St. Thomas as well as professional tenures with both Epic and SPS Commerce. He sits on the board of a family-run non-profit, QuinnEssentials, supporting families with kiddos who have feeding tubes. He lives in St. Paul with his wife and three young kids.
Greg is a health policy consultant and communications specialist, providing strategic oversight and direction to numerous initiatives. Most notably, Greg manages the Alliance for Addiction Payment Reform, a national collaboration aimed at improving outcomes for patients, payers, and health systems, and served as a managing editor of the Addiction Recovery Medical Home Alternative Payment Model.
Greg has over a decade of experience working with non-profits and government agencies on addiction. As person in long-term recovery from addiction himself, Greg’s work has been dedicated towards creating positive changes in access to quality health care and recovery supports for the over 40 million Americans with a substance use disorder.
Greg serves as the Executive Producer of High Watch Media and is the award-winning filmmaker and producer of three feature-length documentaries: The Anonymous People, Generation Found, and Tipping The Pain Scale. In 2015, he executive produced the historic UNITE to Face Addiction Rally on the National Mall when tens of thousands of people including from around the world gathered alongside major musicians to end the silence surrounding addiction. He also produced the 2016 launch event of the first-ever Surgeon’s General Report on Alcohol, Drugs, and Health: Facing Addiction in America as well as the 2021 Recover Out Loud concert event in partnership with Google, iHeart Radio, and Variety. His work has been featured in the New York Times, Washington Post, ABC World News, LA Times, and countless other news outlets.
Greg received his master’s degree in addiction public policy and media production from New York University.
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The GXC Conference 2022 is dedicated to professionals who want to elevate their knowledge regarding therapeutic practices, treatment models, and the latest mental health, addiction, and wellness innovations.