Morning Beach Walk
Begin your day by joining us for a refreshing hour long walk along the ocean on Clearwater Beach! Bottled water to take on your walk will be provided by OPEN MINDS. Meet at the beach entrance by the towel stand at the swimming pool.
Executive Networking Breakfast
Join us this morning for a chance to discuss the coming day's events and have breakfast with each other.
Welcome & Announcement Of The Results From The 2022 OPEN MINDS Performance Management Executive Survey
During this opening session, OPEN MINDS Chief Executive Officer, Monica E. Oss will open the institute by sharing the results of this year's survey, The 2022 OPEN MINDS Performance Management Executive Survey: Where Are We On The Road To Value, and discussing its implications for health and human service organizations.
OPEN MINDS surveyed specialty provider organizations in the health and human services market to determine where they are on the road to value-based contracting adoption. The survey provides information on:
- Performance-based contracts for staff by market and organizational size
- Trends in value-based contracting arrangements by market and organizational size
- The number of organizations with contracts with managed care plans or accountable care organizations by market and organizational size
A full copy of survey results, The 2022 OPEN MINDS Performance Management Executive Survey: Where Are We On The Road To Value, will be available to all Elite members in the OPEN MINDS library following the session.
Monica E. Oss
Monica E. Oss, M.S., Chief Executive Officer and Senior Associate, is the founder of OPEN MINDS. For the past three decades, Ms. Oss has led the OPEN MINDS team and its research on health and human service market trends and its national consulting practice. Ms. Oss is well known for her numerous books and articles focused on the strategic and marketing implications of the evolving health and human service field. She has unique expertise in payer financing models, provider rate setting, and service pricing. She has led numerous engagements with state Medicaid plans, county governments, private insurers, managed care programs, service provider organizations, technology vendors, neurotechnology, and pharmaceutical organizations, and investment banking firms – with a focus on the implications of financing changes on delivery system design.
Improving Access & Collaboration For Complex Consumer Needs: Centene’s Approach To Integrated Care
How can payers and providers enable behavioral and physical care integration? Payers are utilizing metrics and data that can help inform provider organization's clinical and quality areas to measure, which in turn helps them succeed in a value-based contracting model of care. Improving access to care for consumers, requires utilizing vendor platforms, technology, and telehealth, while incorporating behavioral health with primary care. By reducing burdens of care and identifying care gaps, provider organizations can then support their consumers through engagement allowing quality measures to improve. These quality outcome metrics inform the direction of your organization as it provides care to complex consumers, which in turn can position your organization to succeed in a value-based landscape, and can inform the partnerships you are able to create with payers.
Indira Paharia Psy.D., MBA, MS
Dr. Indira Paharia is a licensed clinical psychologist and the Chief Officer for Centene Advanced Behavioral Health. Centene Advanced Behavioral Health serves over 17 million members in 34 states across Medicare, Medicaid, and Marketplace products as part of the Centene Corporation, a Fortune 50 company.
Dr. Paharia has specialized experience in behavioral health managed care, behavioral and physical health integration, and evidence-based programming for vulnerable populations. She has held senior executive and board positions with provider organizations and Fortune 500 companies. Most recently she served as Chief Practice and Performance Officer for a large multistate child-serving provider organization. Previously, she was the National Vice President of Clinical Programs for a Fortune 500 Medicaid Managed Care company, where she led integrated care management for all Medicaid and Medicare members. Prior to this, she was responsible for behavioral health and worksite wellness operations at a multistate BlueCross BlueShield plan for all commercial, Medicare and Medicaid members.
Dr. Paharia currently serves on the board of the Association for Behavioral Health and Wellness. She has served as a delegate at the World Health Assembly, the annual meeting of the World Health Organization and the United Nations, and served as a federally appointed national advisor to SAMHSA for six years. She received her Doctorate in Clinical Psychology from the University of Denver, as well as an MBA in Healthcare Administration and an MS in Healthcare Finance from Temple University with distinction.
She is passionate about ensuring access to high quality behavioral healthcare for our most vulnerable populations.
Thought Leader Discussion
Join us for a follow up session as we engage our keynote presenter in further questions and deeper conversation.
Indira Paharia Psy.D., MBA, MS
Dr. Indira Paharia is a licensed clinical psychologist and the Chief Officer for Centene Advanced Behavioral Health. Centene Advanced Behavioral Health serves over 17 million members in 34 states across Medicare, Medicaid, and Marketplace products as part of the Centene Corporation, a Fortune 50 company.
Dr. Paharia has specialized experience in behavioral health managed care, behavioral and physical health integration, and evidence-based programming for vulnerable populations. She has held senior executive and board positions with provider organizations and Fortune 500 companies. Most recently she served as Chief Practice and Performance Officer for a large multistate child-serving provider organization. Previously, she was the National Vice President of Clinical Programs for a Fortune 500 Medicaid Managed Care company, where she led integrated care management for all Medicaid and Medicare members. Prior to this, she was responsible for behavioral health and worksite wellness operations at a multistate BlueCross BlueShield plan for all commercial, Medicare and Medicaid members.
Dr. Paharia currently serves on the board of the Association for Behavioral Health and Wellness. She has served as a delegate at the World Health Assembly, the annual meeting of the World Health Organization and the United Nations, and served as a federally appointed national advisor to SAMHSA for six years. She received her Doctorate in Clinical Psychology from the University of Denver, as well as an MBA in Healthcare Administration and an MS in Healthcare Finance from Temple University with distinction.
She is passionate about ensuring access to high quality behavioral healthcare for our most vulnerable populations.
Monica E. Oss
Monica E. Oss, M.S., Chief Executive Officer and Senior Associate, is the founder of OPEN MINDS. For the past three decades, Ms. Oss has led the OPEN MINDS team and its research on health and human service market trends and its national consulting practice. Ms. Oss is well known for her numerous books and articles focused on the strategic and marketing implications of the evolving health and human service field. She has unique expertise in payer financing models, provider rate setting, and service pricing. She has led numerous engagements with state Medicaid plans, county governments, private insurers, managed care programs, service provider organizations, technology vendors, neurotechnology, and pharmaceutical organizations, and investment banking firms – with a focus on the implications of financing changes on delivery system design.
How To Change The Medicaid Rules In Your State
Medicaid plans have their challenges. How do Medicaid leaders address shrinking budgets, changing reimbursement models, workforce crises, technology shortcomings, regulatory uncertainty, and many other problems that are both old and new? And what are the implications of these challenges—and the potential solutions—for provider organizations? While trying to make Medicaid rules work for you, your organization, and the consumers you serve and their specific needs it becomes necessary to understand the policy work being done at a state level. How this policy work drives Medicaid rules is becoming an increasingly necessary competency that organizations cannot ignore. To understand health policy is to understand how your operations should be run—having your voice at the table is crucial if you want your consumers to have their voices heard. In this session you can expect to:
- Understand how Medicaid rules affect your organization
- Hear about states and companies that are driving policy change
- Have ideas on how you and your organization can start taking steps to advocate for your consumers at the state level
Ann Rodriguez
Ann Rodriguez is the i2i Center for Integrative Health Executive Director. She provides leadership in all aspects of the organization and works with the Board of Directors to maintain the mission of the organization. She has primary responsibility for the identification of key issues and direction of i2i’s policy work. Ann is an experienced facilitator and plays an integral part in all aspects of collaborative development. She serves as i2i’s representative on a number of statewide committees. Ann values the partnerships and collaborations with all stakeholders of the MH/IDD/SUD system and works to include all stakeholders in policy making.
Ann’s early professional experience included legislative support to the US Senate as well as nursing home administration. Since 1994, through her work with the NC Council of Community Programs, she further developed her skills in lobbying, facilitation, and policy development. Ann is recognized as a key player in the development of numerous policies related to the Medicaid (b)(c) waiver and to general system improvements. Her interest in the health care field was evidenced at an early age through part-time work at local nursing homes, volunteer work with Special Olympics and family member health care. Ann’s deep commitment to supporting a successful public system grew out of personal family experiences where she saw the benefits of public services firsthand.
Ann holds a Master of Health Administration from Tulane University and a BA in Sociology from the University of Maryland. She is a Licensed Nursing Home Administrator in North Carolina.
Carol Clayton, Ph.D.
Dr. Carol Clayton is a licensed, psychologist with 30 years of health care experience in the public and private sector, including non-profit and private practice work. Prior to joining OPEN MINDS as a Senior Consultant, she retired as the Translational Neuroscientist for Relias, where she specialized in health care solutions targeting workforce development and population health outcome improvement. Before joining Relias, Dr. Clayton was the CEO of Care Management Technologies, a health IT data analytics company. She also served as the Executive Director of the NC Council of Community Programs from 2000-2006. The NC Council is the predecessor organization to i2i.
Richard Louis, III
Richard Louis, III has extensive experience as a behavioral healthcare administrator, business development specialist, and innovator of new service lines for behavioral healthcare organizations and currently serves the Vice President – Western Region at OPEN MINDS.
Previously, Mr. Louis was the Director of Development – Behavior & Addiction Medicine at Southern California Healthcare Systems Inc. / Prospect Medical. There, he was involved in many consulting projects focused on health care integration, developing new service lines, and health plan contract development. Most recently, 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. These solutions have shown to reduce payer spend while improving client outcomes for acute care hospital systems, health plans, managed care organizations (MCO), managed service organizations (MSO), managed behavioral healthcare organizations (MBHO), medical groups (IPA) and social service agencies.
Mr. Louis was also the Executive Director of Strategic Development and Planning at Pathways – Molina Healthcare, a national for-profit behavioral healthcare company operating 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 readmissions, emergency department (ED) visits, and improve HEDIS scores for national health plans and Managed Care Organizations.
Mr. Louis is also a former Psychiatric Hospital Administrator and Assistant Director of Mental Health for San Bernardino County Department of Behavioral Health in CA, where he was responsible for behavioral health program management, clinical operations, strategic alliances, and outcome-based service delivery models for complex adult and youth populations.
Mr. Louis also served in various positions at College Health Enterprises (CHE), a Los Angeles based for-profit hospital system, most notably serving as Vice President of Government Operations. While in this role, he created the first public sector division for CHE by establishing new service lines, contracts, and new profit/revenue streams. His responsibilities included business and program development as well as administration of inpatient, outpatient, and residential continuums of care for public payers (i.e. county mental health systems, state department of developmental disabilities, county jail, state prison, and federal government agencies).
Mr. Louis is in his 32nd year as an active duty reserve police officer (volunteer) currently holding the rank of Captain, City of Monterey Park Police Department in Los Angeles County. He has worked closely with police, county sheriff’s departments, and healthcare systems to educate and craft “treatment versus incarceration” collaborations promoting treatment and cost-effective crisis triage interventions for persons with mental illness.
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.
Generating New Revenue With Social Support Programs: Design, ROI Estimates, & Contracting
The growing list of programs focused on the social determinants of health (SDoH) is diverse in approach and size. To deliver better health outcomes, social determinants—including poverty, food insecurity, lack of education, unstable housing, and environmental conditions — must be addressed to find success. But have you examined this as a strategy that affects your outcomes and performance, and do these types of programs work within the framework of your organization?
In this tiered approach, organizations can expect to examine the complexity of SDoH paired with current organizational priorities and services to see where they fit in and how they can affect your business. After this session you can expect to:
- Understand how social determinants of health affect everyday lives
- Learn what part your organization can play in designing this type of program
- Gather ideas for implementation of programs within your organization to positively affect your ROI
Kimberly Bond, MS
Kimberly Bond, MS, LMFT, brings more than 30 years of experience providing behavioral health treatment in the public and community settings to the OPEN MINDS team. She currently serves as the Executive Vice President of Business Development. In this role, Ms. Bond focuses on growing the OPEN MINDS client portfolio across all nine verticals of OPEN MINDS business.
Prior to joining OPEN MINDS, Ms. Bond served concurrently as a Program Coordinator III and Clinical Manager of Adult Services and a Program Coordinator II and Clinical Manager of Recovery Services for the Ozark Guidance Center. In these roles, Ms. Bond was responsible for the administrative and clinical oversight of the adult outpatient and adult intensive mental health services on the Springdale Campus as well as the adult recovery/co-occurring services, including domestic violence and anger management treatment.
Prior to joining the Ozark Guidance Center, Ms. Bond served as the Executive Vice President of Center Point, Inc, a large substance abuse provider agency in California. In this role, Ms. Bond was responsible for the clinical and administrative supervision of all community-based programs as well as the women and children residential programs. In addition, Ms. Bond also managed budgets, interacted with funding agencies, and built positive relationships with all stakeholders. Ms. Bond was also in charge of proposal and grant writing, staff management, and training, facilities’ licensing and certifications renewals. Additionally, she prepared and submitted monthly, quarterly, semi-annual, and annual reports to various funders.
Previously, Ms. Bond served as the President and CEO of Mental Health Systems, Inc. Ms. Bond was very instrumental in growing the agency from $12 million in annual revenue to more than $100 million and becoming one of the largest providers of behavioral health services in California. In this role, Ms. Bond was responsible for the strategic, clinical, financial, and administrative health of the agency, including direct supervision of Senior Executive Staff. In addition, Bond ensured contract compliance of the agency’s 125 different contracts across federal and state agencies and eight counties.
Ms. Bond received her bachelor’s degree in psychology, with honors, and her master’s degree in counseling education from San Diego State University. She is licensed as a Marriage and Family Therapist in both California and Arkansas.
James Stewart
James Stewart brings to OPEN MINDS more than 20 years of experience in the healthcare field. Mr. Stewart has helped develop and modify health care plans and benefits, retirement plans and benefits, and paid time off (PTO) plans for multiple behavioral healthcare providers. He has also had an integral role in program development and business planning for new strategic business lines. Additionally, he has led multiple teams in the selection, implementation, and use of multiple electronic health record (EHR) systems at several behavioral health care entities.
Mr. Stewart currently serves as the Chief Executive Officer at Grafton Integrated Health Network. He previously served as the Executive Vice President, Chief Administrative Officer, where he was responsible for the supervision of the Finance Departments, Contracting (both payer and vendor), Information Technology, Human Resources, Risk Management, Facilities Department, The Infant and Toddler Program, and the Education Department. He has participated and enabled the expansion of services through the acquisition of facilities and extension of the organization’s IT/HR network into Florida and West Virginia in the United States and also in Australia. Mr. Steward also spearheaded the process of developing and implementing a new paperless EHR, as well as a new accounting software that integrated with the electronic clinical record and billing system.
Prior to working at Grafton, Mr. Stewart was the Chief Financial Officer for the Center for Behavioral Health at Centerstone. In this position, he managed the coordination of a multi-disciplinary team through development and implementation of a Davies Award Winning Electronic Health Record. He developed new clinical programs to meet identified locality needs and established a merger between Non-Profit CMHC’s, which crossed state boundaries.
Mr. Stewart received his MBA with a Healthcare Administration focus from Indiana Wesleyan University. He received a Bachelor of Science degree in Accounting from the University of Kentucky.
Major Depressive Disorder In Chronic Kidney Disease
There is a high prevalence of depression among patients with chronic kidney disease (CKD). This presentation will examine the clinical overlap between CKD and major depressive disorder (MDD) in symptomatology, behavioral and biological mechanisms, the impact of comorbid depression on CKD outcomes, and strategies for effective management of depression in CKD.
Aaron Emmel, PharmD, MHA, BCPS
Aaron Emmel, PharmD, MHA, BCPS, joined Otsuka in 2018 and is currently a Senior Clinical & Scientific Liaison on the Nephrology South Team. Dr Emmel earned his Doctor in Pharmacy from the University of Florida in 2007 and his Masters in Health Administration from the University of North Florida in 2015. He has 10 years of experience as a clinical pharmacist, helping to develop and implement numerous clinical programs focused on ICU care, nutrition support, and antimicrobial stewardship. Additionally, he served as an administrator for a multi-specialty Clinically Integrated Network and ACO, helping to develop a Population Health Management strategy that included a coordinated approach to managing Chronic Kidney Disease. He has served as an Associate Clinical Professor for the University of Florida College of Pharmacy, delivering lectures and precepting students on Advanced Pharmacy Practice Experience rotations. Dr Emmel is Board Certified as a Pharmacotherapy Specialist by the Board of Pharmacy Specialties.
Aneta Fornal, PharmD
- Areas of Expertise: Major Depressive Disorder, Bipolar Disorder, Schizophrenia
- Prior Experience: Senior Clinical & Scientific Liaison; Clinical & Scientific Liaison, Medical Information Associate Director, Adjunct Faculty Rutgers School of Pharmacy, Pharmacist
- Schools Attended: University of the Sciences in Philadelphia (Philadelphia, PA)
- Fellowships, Internships, & Residencies: Postdoctoral Fellowship, Rutgers University / Bristol-Myers Squibb Neuroscience Medical Strategy (Plainsboro, NJ)
Paul M. Duck
Paul M. Duck brings more than 40 years of experience in leadership and management focusing on managed care, health information technology organizations, strategy, business development, and market expansion, and customer experience optimization to the OPEN MINDS team.
Prior to joining OPEN MINDS, Mr. Duck served as the Vice President, Strategy & Development at Beacon Health Options. In this role, Mr. Duck led the organization’s strategy and business development efforts, which led to a 30% increase in net revenue and initiated more than $1 billion in revenue generation. Mr. Duck was active in national behavioral health initiatives as an executive of Beacon Health Options, including participating as a speaker at national and state association meetings.
Before joining Beacon Health Options, Mr. Duck was the Vice President of Business Development at Netsmart Technologies. During his tenure, Mr. Duck was responsible for business planning including the oversight of strategic activities including acquisitions, development, and execution of strategic initiatives, and positioning, and sales of large strategic customers. He also led the rollout of the company’s benchmarking and data analytics product suite.
Prior to Netsmart, Mr. Duck served as the Chief Executive Officer for Coastal Orthopedics and Pain Management, a large group practice with five clinic locations and two ambulatory surgical centers. As the organization’s chief executive officer, Mr. Duck was responsible for significant positive changes in leadership and corporate culture, financial and operational performance, compliance, and governance. Mr. Duck improved net collections by over $1 million per month and grew the practice through negotiating better contract rates with payers. He also implemented an organizational rebranding initiative and launched a new marketing campaign.
Prior to Coastal Orthopedics and Pain Management, Mr. Duck served as the President and Chief Executive Officer for Florida Radiology Imaging, one of the largest outpatient diagnostic imaging service companies serving the greater Orlando market. During his tenure, Mr. Duck led the construction of three new, full modality, diagnostic imaging locations. Mr. Duck revolutionized the company’s culture by creating a highly attractive and functional work environment.
Mr. Duck earned his Bachelor of Arts in Business Management from Case Western Reserve University. He earned his Associate of Arts in Electronic Engineering Technology from the Electronic Technology Institute. Mr. Duck received an award by Inc magazine for leading Florida Radiology Imaging as one of America’s fastest-growing companies. Mr. Duck recently served as a contributing author to the book The New Health Age: The Future of Health Care in America.
Lunch On Your Own
Visit our partners and affiliates in our exhibit hall!
Post Lunch Pick Me Up
Grab a sweet treat after lunch! From 1:30 pm to 2:00 pm, visit the exhibit hall for an assortment of ice cream classics. Create your own sundae with toppings, syrup, and warm cookies.
Realigning Your Portfolio – What Services Survive?
How does a provider’s organizational strategy and service line availability need to evolve to maintain competitive advantage and sustainability? Executives cannot remain complacent with the status quo; they need to be able to identify what is feasible to keep and cultivate, and what can be “cut from the vine.” The time for tough conversations within your organization is now. Will you evolve and grow? If so, can you make the call on what needs to be cut? In this session, we will discuss everything you need to know about developing a comprehensive strategy for streamlining your organization for profitability and sustainability, including:
- Establishing criteria for what you can release from your service line
- Evaluating your service areas within your existing organization with an objective lens
- Realigning your strategic vision and opportunities for the “next normal”
Joseph P. Naughton-Travers, Ed.M.
Joseph P. Naughton-Travers, Ed.M., Senior Associate, has more than 30 years of experience in the health and human service field. In this tenure as senior associate with OPEN MINDS since 1998, he has served as lead of dozens of client initiatives, served as editor of OPEN MINDS publications, and is the author of many groundbreaking articles and presentations.
Mr. Naughton-Travers brings to OPEN MINDS a broad range of experiences in private and public sector delivery of behavioral health and social services. He started his career as a behavioral health clinician, working in both child welfare and community mental health clinic settings. Subsequently, Mr. Naughton-Travers held a senior business operations management position for a psychiatric hospital system and its community mental health clinics. Later, he was vice president of a firm specializing in information systems and billing and receivables management for community-based mental health programs.
Since joining OPEN MINDS, Mr. Naughton-Travers has developed business solutions for provider and professional organizations, state and county government, technology companies, and venture capital firms. His primary areas of expertise include strategic planning and metrics-based management, electronic health record (EHR) and technology selection and implementation, operations improvement, and corporate compliance. For the past decade, more than half of his consulting practice has focused on aiding organizations in technology selection and implementation, including all aspects of strategic technology planning, functional specifications development, request for proposal development, vendor selection, and contracting.
He has written numerous articles, including “Winning the Human Resource Wars: Tried, True and New Strategies for Behavioral Health and Social Service Organizations,” “Five Pillars of Management Competency,” “Data Driven Decision Making: Moving to an Organizational Measurement Culture,” “Survival of the Smartest: What is Your Organization’s Information Literacy IQ?,” and “Strategic Human Resource Management: Aligning Compensation with Employee Performance and Organizational Strategy.” Mr. Naughton-Travers is also a nationally recognized speaker, having conducted hundreds of executive and professional executive training events around the nation.
Mr. Naughton-Travers received his Bachelor’s degree from Miami University of Ohio and his Masters’ of Education in Counseling Psychology from Boston University.
Emily Korns, MBA, RDN
Emily Korns, MBA, RDN brings nearly 20 years of health care marketing and communications experience to OPEN MINDS. Having started her career as a Program Manager for the Allegheny County Health Department where she developed and delivered behavior change and education programs designed to prevent chronic disease in vulnerable populations throughout greater Pittsburgh, PA, Ms. Korns brings a similar focus on population health, wellness, and nutrition expertise to OPEN MINDS.
Most recently, Ms. Korns was the Director of Communications and Marketing for Conemaugh Health System in Johnstown, PA, part of Duke Lifepoint Healthcare, where she led marketing communications for the health system’s four hospitals, outpatient clinics, and 40+ physician practices. Ms. Korns managed, executed, and measured the ROI of the department’s $1.4 million budget and served on the executive leadership team. During her tenure with the health system, Ms. Korns directed external media relations, internal communications strategies, and executed digital and social media, advertising, and sponsorship campaigns focused on consumer access. Ms. Korns implemented service line launches, regional expansion projects, and organization change initiatives that led to revenue and EBITDA growth exceeding budget targets.
A Look At Incentive Compensation Programs For Teams – What Are They & What Effect Do They Have?
Employers have had to get creative with compensation and competitive wages for the workforce over the past ten years. When operating under thin reimbursement margins, this is a challenge, but it can be done. Highly productive staff have increased options for employment, so the ability to retain your top talent is a skill you need. Hear about the framework that organizations can use to successfully utilize an incentive compensation program and take away the following from this session:
- An understanding of your costs and how to incorporate this strategy into your retention plan
- The benefits of adopting an incentive compensation program
- An understanding of incentive compensation programs and the benefits of each
Paul M. Duck
Paul M. Duck brings more than 40 years of experience in leadership and management focusing on managed care, health information technology organizations, strategy, business development, and market expansion, and customer experience optimization to the OPEN MINDS team.
Prior to joining OPEN MINDS, Mr. Duck served as the Vice President, Strategy & Development at Beacon Health Options. In this role, Mr. Duck led the organization’s strategy and business development efforts, which led to a 30% increase in net revenue and initiated more than $1 billion in revenue generation. Mr. Duck was active in national behavioral health initiatives as an executive of Beacon Health Options, including participating as a speaker at national and state association meetings.
Before joining Beacon Health Options, Mr. Duck was the Vice President of Business Development at Netsmart Technologies. During his tenure, Mr. Duck was responsible for business planning including the oversight of strategic activities including acquisitions, development, and execution of strategic initiatives, and positioning, and sales of large strategic customers. He also led the rollout of the company’s benchmarking and data analytics product suite.
Prior to Netsmart, Mr. Duck served as the Chief Executive Officer for Coastal Orthopedics and Pain Management, a large group practice with five clinic locations and two ambulatory surgical centers. As the organization’s chief executive officer, Mr. Duck was responsible for significant positive changes in leadership and corporate culture, financial and operational performance, compliance, and governance. Mr. Duck improved net collections by over $1 million per month and grew the practice through negotiating better contract rates with payers. He also implemented an organizational rebranding initiative and launched a new marketing campaign.
Prior to Coastal Orthopedics and Pain Management, Mr. Duck served as the President and Chief Executive Officer for Florida Radiology Imaging, one of the largest outpatient diagnostic imaging service companies serving the greater Orlando market. During his tenure, Mr. Duck led the construction of three new, full modality, diagnostic imaging locations. Mr. Duck revolutionized the company’s culture by creating a highly attractive and functional work environment.
Mr. Duck earned his Bachelor of Arts in Business Management from Case Western Reserve University. He earned his Associate of Arts in Electronic Engineering Technology from the Electronic Technology Institute. Mr. Duck received an award by Inc magazine for leading Florida Radiology Imaging as one of America’s fastest-growing companies. Mr. Duck recently served as a contributing author to the book The New Health Age: The Future of Health Care in America.
Ken Carr
Ken Carr brings more than 20 years of finance, technology, data analysis, and reporting experience in the health and human services field to OPEN MINDS. He currently is a Senior Associate with the OPEN MINDS consulting practice. In this role, he has served as a subject matter expert leading numerous engagements in strategic planning, merger and acquisition prospecting, business process improvement, financial analysis of service lines, and technology selection.
Before joining the OPEN MINDS team, he served as the Chief Financial Officer of The Centers, a community mental health center in Ocala, Florida. In this position, Mr. Carr led a realignment of the organization’s financial management functions. This included revenue cycle management, EHR bill implementation and reporting, cash management enhancement, and strategic financial analysis.
Prior to his role at The Centers, Mr. Carr served as Chief Financial Officer of Guild Incorporated, an organization providing residential and community based mental health services in St. Paul, Minnesota. As CFO, Mr. Carr led the financial, billing, IT, quality, informatics, compliance, and facilities activities. During his tenure at Guild Incorporated, Mr. Carr used his expertise in change management and business process improvement to lead the EHR implementation team, align service data reporting and financial performance, and lead the financial and data capture activities for new service initiatives.
Mr. Carr has also held the positions of Administrative Director and Finance Director at the St. Paul National Testing Laboratory, a biomedical testing facility of the American Red Cross. In those positions he oversaw activities to enhance inventory management, align financial results to industry standards, and improve financial and facilities performance through problem analysis and quality management initiatives. He also was involved in directing human resource functions during laboratory closing near the end of his tenure.
Mr. Carr earned a Bachelor of Science in Business Administration from the University of South Dakota and a Master of Divinity Degree from Sioux Falls Seminary. He maintains an active CPA license with the State of South Dakota.
Using Technology To Increase Client Engagement
The need for Communication, Collaboration, and Client Engagement is at an all-time high; however, selecting and implementing the right solutions can be a challenging process. Join us for a panel presentation discussing the top tools and strategies used by executive leaders at behavioral health organizations to improve engagement in a remote-first world and produce transformative outcomes with technology.
Heather Nower, LCSW
Heather Nower, LCSW is the Director of Operations and Program Excellence at the Mental Health Association of the Southern Tier in Binghamton, NY. Heather has played an integral part in: implementation and maintenance of the agency’s electronic medical record; evaluation and quality oversight of the agency services; bringing programs into compliance with NYS Office of Mental Health regulations to secure designation/licensure as an approved provider of HCBS Peer Empowerment, Crisis Stabilization for children/youth, Family Peer Support Services, and Residential Crisis Support Services.; and was part of a team that created the infrastructure, training, and compliance standards that have allowed the organization to successfully bill and receive payment for services for the first time in the organization’s 95 year history.
Prior to joining the Mental Health Association of the Southern Tier, Heather worked for Insight House (now Helio Health) in Utica NY, the Community Recovery Center of Rome Memorial Hospital, and Cayuga Addiction Recovery Services in Ithaca, NY providing and eventually overseeing an array of clinical services under the NYS Office of Addiction Services and Supports. For 20+ years she compassionately and tirelessly offered clinical services ranging from outpatient to intensive outpatient/day rehabilitation, up to long term residential care to individuals and families living with substance use disorders.
Heather also has experience with program development, corporate compliance, professional staff development, and the creation and implementation of organizational policy. She has been a key part of successful implementation of 3 different electronic medical records across different organizations.
Heather is a graduate of SUNY Buffalo where she obtained a Master’s in Social Work; and also has a BA in Psychology from Keuka College.
Matthew Welser
Matt’s education in psychology and background experience as a direct service provider gives him a unique perspective on the technological needs of behavioral health and social service organizations. Matt served as a direct care provider for youth and families with mental health needs before his professional journey took a turn in 2014, when Matt was asked to become the Welligent Electronic Health Record Administrator for Pinebrook Family Answers.
Technology has long been Matt’s passion making this transition to Information Technology a natural fit. In less than a year Matt progressed to the role of Information Systems Manager and became of member of the agency’s administrative team.
In his current role as the Innovative Technology Analyst, Matt is tasked with maximizing the use of current IT systems and technologies while exploring new ones with the goal of advancing Pinebrook’s mission. Matt is now going on 8 years as a local Welligent administrator. During that time Matt has managed and provided end user training for multiple Welligent implementations across a verity of different behavioral health and social service programs. Matt is frequently sought out by other agencies in the local community for guidance with Welligent. Matt also administrates 5 additional SaaS systems including Microsoft Offices 365 and has experience with IT consulting and project management.
Rich Daly
Rich Daly began his work in behavioral health with UPMC’s Askesis Development Group and cognitive behavioral therapy software Beating the Blues, and joined the Welligent team in 2017.
Rich brings EHR and other behavioral health software experience in sales and marketing, customer relationship management, and project management roles. His experience includes technology leveraged by community mental health centers, inpatient psychiatric units, intellectual and developmental disabilities providers, addictions treatment facilities, community-based service providers, and school-based behavioral health and nursing providers.
Since joining Welligent Rich has aided in expansion into new states, new customer service lines and clinical settings, and product enhancements related to key provider markets. Rich focuses on the goal of enhancing provider agencies’ competitive advantage and providing clients with the ability to engage in their care through the use of technology.
Cutting Readmissions: A Case Study In How Organizations Are Tackling This Problem With Complex Consumers
Many provider organizations, from hospital systems to skilled nursing facilities and home health organizations, are concerned with readmission rates. Often these readmission rates are affected by a slim margin of the population with the most complex needs (behavioral and mental health, cognitive challenges, homelessness, substance use, and complex comorbidities) and who are the highest utilizers of these systems. So, what can be done to combat the “revolving door syndrome” that health systems face? Hear from organizations across the nation that are getting creative and tackling this issue head on. Expect to take away:
- Creative solutions to this complex issue for complex consumers
- An ability to identify how your organization can become part of the solution
- A balance between meeting the needs of your high utilizer consumers and positive outcomes
Sharon Hicks
Sharon Hicks, OPEN MINDS Senior Associate, has more than 20 years of experience in the health and human service field. She has extensive experience and wide range of expertise in health plan management, in clinical operations management, and technology.
Prior to joining OPEN MINDS, Ms. Hicks spent two decades in a number of executive positions within the University of Pittsburgh Medical Center (UPMC) system and within its health plan division. Ms. Hicks served as the Chief Operating Officer for Community Care Behavioral Health, a managed behavioral health organization. There she was responsible for all aspects of the organization’s operations including fiscal, information systems, the claims processing department, and the design of clinical systems. In addition, Ms. Hicks managed the day-to-day operations of including human resources, facilities, purchasing, and security.
Ms. Hicks also served as the Vice President, Internet Strategy, UPMC Insurance Services Division and, since 2002, as the Chief Executive Officer of Askesis Development Group, Inc. In this role, Ms. Hicks was responsible for the growth of the company, profitability of the company, and the direction of software development.
Ms. Hicks started her impressive health care career as a psychiatric social worker before being promoted to Assistant Director of Social Work. Prior to her executive promotions, Ms. Hicks served as a Clinical Administrator for both Ambulatory Services and Emergency and Intake Services at the UPMC Western Psychiatric Institute and Clinic. In this role, she managed the behavioral health division, the budgets for all departments, and implemented new software replacing paper billing for clinical services.
Ms. Hicks received both her Masters of Business Administration and Masters of Social Work degrees from the University of Pittsburg. Before pursuing her graduate education, Ms. Hicks received her Bachelor’s Degree in Psychology.
Jason Lippman
Jason Lippman brings over 15 years of executive experience in the health and human services field to the OPEN MINDS team, with expertise in health care strategy, public policy and government relations, managed care, and communications. Prior to his role with OPEN MINDS, Mr. Lippman served as the Vice President of Strategy & Development for Beacon Health Options. In this role, Mr. Lippman developed strategic relationships and solutions to facilitate new growth. He also identified opportunities to integrate physical and behavioral health services to improve both quality and affordability.
Before his time with Beacon Health Options, Mr. Lippman served as the Executive Vice President of The Coalition for Behavioral Health, a New York-state based behavioral health provider association. In that role, he was responsible for operations, development, financial management, and member services. Mr. Lippman also secured $263,000 to drive provider business transformation and established a Regional Addiction Resource Center and an e-learning system for over 6,000 users.
During his tenure at The Coalition for Behavioral Health, Mr. Lippman also served as Interim President and Chief Executive Officer. In this role, he developed and implemented a strategic restructuring plan that achieved 23% savings and realigned $1.5 million in contracted training programs into a center for excellence to maximize value and achieve operational efficiencies.
Prior to his role with The Coalition for Behavioral Health, Mr. Lippman was the Director of Public Policy & Government Relations for Amida Care, a New York City-based Medicaid health plan. In this role, Mr. Lippman served as the lead for Medicaid redesign strategies and delivery system reform initiatives. He secured a $500,000 DSRIP planning grant and over $100,000 in New York City Council funding for member-driven health and wellness programs.
Earlier in his career, Mr. Lippman served as a Director of Policy and Advocacy for The Coalition of Behavioral Health Agencies, where he advanced policy strategies to increase opportunities for membership under healthcare reform. Mr. Lippman’s efforts increased the number of advocates and members by more than 30%.
Mr. Lippman received a Master of Arts in Public Affairs and Policy from the Rockefeller College of Public Affairs and Policy at the University of Albany. He also received Bachelor of Arts in Political Science from Binghamton University.
Rising Wage Rates: How Do You Manage Your Margins & Unit Costs
The intricacies of managing your margins and your unit costs can be confounded by rising wage rates, especially when many organizations are operating on extremely thin margins. Savvy finance professionals are in dire need, but there are steps you can take within your organization now to meet these challenges and remain both viable and sustainable. The typical fee-for-service “money makers” are shrinking, so understanding how to offset costs and operate with quality outcomes, all while managing rising wage rates, is imperative to your organizational sustainability and performance optimization. In this session you can expect to:
- Hear from organizations that are making this work in real time
- Understand how to maneuver and shift your unit costs
- Learn from finance professionals that can provide you with working solutions
James Stewart
James Stewart brings to OPEN MINDS more than 20 years of experience in the healthcare field. Mr. Stewart has helped develop and modify health care plans and benefits, retirement plans and benefits, and paid time off (PTO) plans for multiple behavioral healthcare providers. He has also had an integral role in program development and business planning for new strategic business lines. Additionally, he has led multiple teams in the selection, implementation, and use of multiple electronic health record (EHR) systems at several behavioral health care entities.
Mr. Stewart currently serves as the Chief Executive Officer at Grafton Integrated Health Network. He previously served as the Executive Vice President, Chief Administrative Officer, where he was responsible for the supervision of the Finance Departments, Contracting (both payer and vendor), Information Technology, Human Resources, Risk Management, Facilities Department, The Infant and Toddler Program, and the Education Department. He has participated and enabled the expansion of services through the acquisition of facilities and extension of the organization’s IT/HR network into Florida and West Virginia in the United States and also in Australia. Mr. Steward also spearheaded the process of developing and implementing a new paperless EHR, as well as a new accounting software that integrated with the electronic clinical record and billing system.
Prior to working at Grafton, Mr. Stewart was the Chief Financial Officer for the Center for Behavioral Health at Centerstone. In this position, he managed the coordination of a multi-disciplinary team through development and implementation of a Davies Award Winning Electronic Health Record. He developed new clinical programs to meet identified locality needs and established a merger between Non-Profit CMHC’s, which crossed state boundaries.
Mr. Stewart received his MBA with a Healthcare Administration focus from Indiana Wesleyan University. He received a Bachelor of Science degree in Accounting from the University of Kentucky.
Mary Ann Kowalonek , MSL, CPA, CGMA
Mary Ann is the Vice-President and Chief Financial Officer at Service Access & Management, Inc., a NACM Charter Member organization. SAM, Inc. is a human service organization serving over 25,000 individuals in 60 counties in the state of Pennsylvania. She is a Pennsylvania State University graduate, where she earned a Bachelor’s Degree in Accounting, and she is currently a Certified Public Accountant and Chartered Global Management Accountant. Additionally, she earned her Masters of Science Degree in Leadership.
Mary Ann has over 35 years of progressive management experience in not-for-profit, financial services, administration, and public accounting sectors. Her areas of expertise include organizational leadership strategies, strategic planning, financial analysis, and financial reporting. Mary Ann joined the NACM board in 2012 and currently serves as the Association’s Treasurer.
Ken Carr
Ken Carr brings more than 20 years of finance, technology, data analysis, and reporting experience in the health and human services field to OPEN MINDS. He currently is a Senior Associate with the OPEN MINDS consulting practice. In this role, he has served as a subject matter expert leading numerous engagements in strategic planning, merger and acquisition prospecting, business process improvement, financial analysis of service lines, and technology selection.
Before joining the OPEN MINDS team, he served as the Chief Financial Officer of The Centers, a community mental health center in Ocala, Florida. In this position, Mr. Carr led a realignment of the organization’s financial management functions. This included revenue cycle management, EHR bill implementation and reporting, cash management enhancement, and strategic financial analysis.
Prior to his role at The Centers, Mr. Carr served as Chief Financial Officer of Guild Incorporated, an organization providing residential and community based mental health services in St. Paul, Minnesota. As CFO, Mr. Carr led the financial, billing, IT, quality, informatics, compliance, and facilities activities. During his tenure at Guild Incorporated, Mr. Carr used his expertise in change management and business process improvement to lead the EHR implementation team, align service data reporting and financial performance, and lead the financial and data capture activities for new service initiatives.
Mr. Carr has also held the positions of Administrative Director and Finance Director at the St. Paul National Testing Laboratory, a biomedical testing facility of the American Red Cross. In those positions he oversaw activities to enhance inventory management, align financial results to industry standards, and improve financial and facilities performance through problem analysis and quality management initiatives. He also was involved in directing human resource functions during laboratory closing near the end of his tenure.
Mr. Carr earned a Bachelor of Science in Business Administration from the University of South Dakota and a Master of Divinity Degree from Sioux Falls Seminary. He maintains an active CPA license with the State of South Dakota.
Ray Wolfe, J.D.
Raymond “Ray” Wolfe, J.D. brings over 40 years of experience in the health and human services sector to the OPEN MINDS team. Mr. Wolfe currently serves as a Senior Associate, a position in which he utilizes his expertise to successfully lead varying projects for OPEN MINDS. His areas of expertise include financial analysis and management, mergers and acquisitions, performance improvement, and strategic planning.
Before joining OPEN MINDS, Mr. Wolfe served in a 22 year tenure with Pittsburgh Mercy Health System in Pittsburgh, Pennsylvania. Most recently, Mr. Wolfe served as the organization’s Chief Operating Officer (COO) where he was responsible for oversight of all system operations, strategic planning, and performance management. Under his direction Pittsburgh Mercy achieved over $850K in value-based reimbursement contract quality bonus awards, integrated three organizations through merger/acquisition, and adopted a new performance management program for managers.
Before acting as Pittsburgh Mercy’s COO, Mr. Wolfe served as the organization’s Chief Financial Officer (CFO) and was responsible for the development of internal costing methodologies, contract rate negotiations, and financial forecasting activities. In addition, he coordinated an integrated care program with local partner hospitals to develop a series of diversion and respite programs, as well as, specialized primary care, integrated care management and high utilizer teams, while maintaining 15 straight years profitability.
Mr. Wolfe was promoted to CFO after serving as the Director of Fiscal and Information Security/Compliance for the health system. In this role, he was responsible for managing the transition of service contracts from fee-for-service (FFS), leading all compliance activities, and implementing a next generation electronic health record (EHR) system.
Prior to his time at Pittsburgh Mercy Health System, Mr. Wolfe served as Chief Fiscal Officer with the Summit Center for Human Development in Clarksburg, West Virginia, where he was responsible for reporting and budgeting functions and preparing Summit Center’s programs for FFS billing.
Previously, Mr. Wolfe served in billing and collections for two Pennsylvania-based hospitals. First, as an Accounts Receivables Manager for Brownsville General Hospital in Brownsville, PA, where he managed the accounting and billing system transition systems. Later as a Patient Account Manager for St. Francis Medical Center in Pittsburgh, PA, where he improved collections to hit 95% rate through the implementation of new billing software and department reorganization.
Prior to working in the health and human services market, Mr. Wolfe spent five years practicing as a Lawyer with at Law Offices of Arch A. Moore in Moundsville, WV. In this role he provided general legal practice, created and established bylaws for multiple corporation, and handled West Virginia licensing of first vision insurance plan.
Mr. Wolfe earned his Juris Doctor from the West Virginia University School of Law in Morgantown, WV and his Bachelor’s degree with a focus in Political Science and Sociology from West Liberty University, in Wheeling, WV, where he graduated Magna Cum Laude.
The AI Trifecta: Staff Retention + Maximized Reimbursement + Improved Clinical Care
Organizations that are embracing new technology as a way to support their workforce are finding that they are able to lighten the load on providers once and for all, resulting in happier staff, increased revenue and better client outcomes, as evidenced by several provider case studies.
During this insightful session, learn how two technology leaders have joined forces to bring this technology and much more to human services organizations.
You’ll leave the event with an understanding of:
- Ways to address one of the most pressing challenges faced by human service organizations today
- How advanced technology is transforming the EHRs ability to provide end user satisfaction
- How to drive efficiency, retain staff and boost revenue with AI
- Supporting a workforce by looking at technology through a new lens
Neal Tilghman
As General Manager of Integrated Care, Neal Tilghman endorses a client focused and strategic market model around Netsmart’s solutions with a keen awareness of the current state of behavioral health, addictions treatment and physical health, while maintaining a forward-looking approach as to where our clients need to be and how we get them there with the appropriate technology. As an advocate of integrated care and its inclusion of addictions, Neal promotes whole-person care as the best means to improve patient care, achieve better outcomes and reduce costs. Neal completed his graduated studies at East Carolina University and has 30 years of experience in behavioral health.
Peter Flick
Peter Flick, General Manager of Bells, Netsmart
Peter is the current GM and Vice President of Bells, a business unit of Netsmart which acquired Remarkable Health and Bells in 2021. Prior to the acquisition, Peter was the Founder and CEO of Remarkable Health, a Scottsdale-based software company for the behavioral health and human services industry. In 2014, Peter created an investment vehicle to pursue the idea of Remarkable Health, and in 2015, led the acquisition of ClaimTrak, an EHR software pioneer for the behavioral health industry. Post-acquisition, the company launched an enhanced CT|One, a fully integrated EHR. Then in 2021, the company launched Bells.ai, the first virtual clinical documentation assistant for the behavioral health and human services industry.
Previously, Peter co-founded Relay Network, the leading mobile consumer engagement platform for the commercial health insurance industry. At Relay, Peter held early roles as CFO and then VP of Product. He managed the product and technology team, released several products, is an inventor on a mobile communication patent, and led $18M in venture financing.
Earlier in his career, Peter worked at Spectrum Equity Investors in Boston, a $4 billion private equity firm focused on investing in technology and healthcare service companies. Before Spectrum, Peter was an analyst in the Leveraged Finance Group of Citigroup and served as an analyst at Graham Partners.
Peter graduated from Villanova University with a Bachelor of Science in Business Administration, where he played Division 1 lacrosse, started and managed an industrial cleaning company (while attending night school), and co-founded the Villanova Entrepreneurial Society.
Currently, Peter lives in Villanova with his wife and three children.
Carol Clayton, Ph.D.
Dr. Carol Clayton is a licensed, psychologist with 30 years of health care experience in the public and private sector, including non-profit and private practice work. Prior to joining OPEN MINDS as a Senior Consultant, she retired as the Translational Neuroscientist for Relias, where she specialized in health care solutions targeting workforce development and population health outcome improvement. Before joining Relias, Dr. Clayton was the CEO of Care Management Technologies, a health IT data analytics company. She also served as the Executive Director of the NC Council of Community Programs from 2000-2006. The NC Council is the predecessor organization to i2i.
Executive Networking Reception
Grab a drink and join us for a chance to continue the discussions of the day and network.
Executive Networking Breakfast
Join us this morning for a chance to discuss the coming day's events and have breakfast with each other.
You Can’t Have One Without The Other: Making Health Plan Data Analytics Work For Provider Organizations
You have likely been hearing it everywhere you go – data is king. But what does that mean for provider organizations serving complex consumers in the health and human services field? How can your organization make strategic changes within your systems to optimize performance, address key clinical outcome measures, and position your company for sustainability in the ‘next normal’? Health plans are data gathering giants, and now, more than ever, they can help inform your strategy for growth. But you have to know what data they have, be clear about what to ask for, and how to put the data you are given into actionable strategy for improving the performance of your organization.
Join our keynote speaker as they delve into the ever-evolving relationship between payers and providers and offer innovative areas of opportunity utilizing shared data and recent real-life examples of implementation. Discover how health plans and your organization can do this together to create successful sustainability in the ‘next normal’.
Eric Bailly, LPC, LADCBusiness Solutions Director, Behavioral Health Clinical Strategy, Anthem, Inc.
Eric Bailly, LPC, LADC
Eric Bailly is currently a Business Solutions Director at Anthem, Inc. In his 11th year at Anthem, Eric’s role is focused on the enterprise substance use disorder strategy, with recent emphasis on the enterprise opioid strategy.
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.
Thought Leader Discussion With Eric Bailly, LPC, LADC, Business Solutions Director, Anthem, Inc.
Join us for a follow up session as we engage our keynote presenter in further questions and deeper conversation.
Eric Bailly, LPC, LADCBusiness Solutions Director, Behavioral Health Clinical Strategy, Anthem, Inc.
Eric Bailly, LPC, LADC
Eric Bailly is currently a Business Solutions Director at Anthem, Inc. In his 11th year at Anthem, Eric’s role is focused on the enterprise substance use disorder strategy, with recent emphasis on the enterprise opioid strategy.
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.
Ken Carr
Ken Carr brings more than 20 years of finance, technology, data analysis, and reporting experience in the health and human services field to OPEN MINDS. He currently is a Senior Associate with the OPEN MINDS consulting practice. In this role, he has served as a subject matter expert leading numerous engagements in strategic planning, merger and acquisition prospecting, business process improvement, financial analysis of service lines, and technology selection.
Before joining the OPEN MINDS team, he served as the Chief Financial Officer of The Centers, a community mental health center in Ocala, Florida. In this position, Mr. Carr led a realignment of the organization’s financial management functions. This included revenue cycle management, EHR bill implementation and reporting, cash management enhancement, and strategic financial analysis.
Prior to his role at The Centers, Mr. Carr served as Chief Financial Officer of Guild Incorporated, an organization providing residential and community based mental health services in St. Paul, Minnesota. As CFO, Mr. Carr led the financial, billing, IT, quality, informatics, compliance, and facilities activities. During his tenure at Guild Incorporated, Mr. Carr used his expertise in change management and business process improvement to lead the EHR implementation team, align service data reporting and financial performance, and lead the financial and data capture activities for new service initiatives.
Mr. Carr has also held the positions of Administrative Director and Finance Director at the St. Paul National Testing Laboratory, a biomedical testing facility of the American Red Cross. In those positions he oversaw activities to enhance inventory management, align financial results to industry standards, and improve financial and facilities performance through problem analysis and quality management initiatives. He also was involved in directing human resource functions during laboratory closing near the end of his tenure.
Mr. Carr earned a Bachelor of Science in Business Administration from the University of South Dakota and a Master of Divinity Degree from Sioux Falls Seminary. He maintains an active CPA license with the State of South Dakota.
Taking Value-Based Contracts To Scale – Is It Working?
The common thread for all value-based contract models is that the consumer is at the center of all care decisions and payment is based on clinical outcomes, not volume of services provided. Metrics-driven outcomes, consumer satisfaction, and sound best practices all play a part in reimbursement, and we are starting to see some organizations flounder, and some soar. Managing for profitability as your organization delves headlong into value-based reimbursement is the new key to sustainability. Learn all you need to know about value-based contract negotiation and evaluation of market opportunities that minimize risk and the ones that catalyze rapid growth. Hear from industry leaders who have lived to tell the tale. From this session you can expect:
- An overview of the implementation process for clinical models within value-based contracts
- An evaluation of market opportunities to help you build on success
- Case studies of organizations that have built effective models within their value-based contracts
Joseph P. Naughton-Travers, Ed.M.
Joseph P. Naughton-Travers, Ed.M., Senior Associate, has more than 30 years of experience in the health and human service field. In this tenure as senior associate with OPEN MINDS since 1998, he has served as lead of dozens of client initiatives, served as editor of OPEN MINDS publications, and is the author of many groundbreaking articles and presentations.
Mr. Naughton-Travers brings to OPEN MINDS a broad range of experiences in private and public sector delivery of behavioral health and social services. He started his career as a behavioral health clinician, working in both child welfare and community mental health clinic settings. Subsequently, Mr. Naughton-Travers held a senior business operations management position for a psychiatric hospital system and its community mental health clinics. Later, he was vice president of a firm specializing in information systems and billing and receivables management for community-based mental health programs.
Since joining OPEN MINDS, Mr. Naughton-Travers has developed business solutions for provider and professional organizations, state and county government, technology companies, and venture capital firms. His primary areas of expertise include strategic planning and metrics-based management, electronic health record (EHR) and technology selection and implementation, operations improvement, and corporate compliance. For the past decade, more than half of his consulting practice has focused on aiding organizations in technology selection and implementation, including all aspects of strategic technology planning, functional specifications development, request for proposal development, vendor selection, and contracting.
He has written numerous articles, including “Winning the Human Resource Wars: Tried, True and New Strategies for Behavioral Health and Social Service Organizations,” “Five Pillars of Management Competency,” “Data Driven Decision Making: Moving to an Organizational Measurement Culture,” “Survival of the Smartest: What is Your Organization’s Information Literacy IQ?,” and “Strategic Human Resource Management: Aligning Compensation with Employee Performance and Organizational Strategy.” Mr. Naughton-Travers is also a nationally recognized speaker, having conducted hundreds of executive and professional executive training events around the nation.
Mr. Naughton-Travers received his Bachelor’s degree from Miami University of Ohio and his Masters’ of Education in Counseling Psychology from Boston University.
Ray Wolfe, J.D.
Raymond “Ray” Wolfe, J.D. brings over 40 years of experience in the health and human services sector to the OPEN MINDS team. Mr. Wolfe currently serves as a Senior Associate, a position in which he utilizes his expertise to successfully lead varying projects for OPEN MINDS. His areas of expertise include financial analysis and management, mergers and acquisitions, performance improvement, and strategic planning.
Before joining OPEN MINDS, Mr. Wolfe served in a 22 year tenure with Pittsburgh Mercy Health System in Pittsburgh, Pennsylvania. Most recently, Mr. Wolfe served as the organization’s Chief Operating Officer (COO) where he was responsible for oversight of all system operations, strategic planning, and performance management. Under his direction Pittsburgh Mercy achieved over $850K in value-based reimbursement contract quality bonus awards, integrated three organizations through merger/acquisition, and adopted a new performance management program for managers.
Before acting as Pittsburgh Mercy’s COO, Mr. Wolfe served as the organization’s Chief Financial Officer (CFO) and was responsible for the development of internal costing methodologies, contract rate negotiations, and financial forecasting activities. In addition, he coordinated an integrated care program with local partner hospitals to develop a series of diversion and respite programs, as well as, specialized primary care, integrated care management and high utilizer teams, while maintaining 15 straight years profitability.
Mr. Wolfe was promoted to CFO after serving as the Director of Fiscal and Information Security/Compliance for the health system. In this role, he was responsible for managing the transition of service contracts from fee-for-service (FFS), leading all compliance activities, and implementing a next generation electronic health record (EHR) system.
Prior to his time at Pittsburgh Mercy Health System, Mr. Wolfe served as Chief Fiscal Officer with the Summit Center for Human Development in Clarksburg, West Virginia, where he was responsible for reporting and budgeting functions and preparing Summit Center’s programs for FFS billing.
Previously, Mr. Wolfe served in billing and collections for two Pennsylvania-based hospitals. First, as an Accounts Receivables Manager for Brownsville General Hospital in Brownsville, PA, where he managed the accounting and billing system transition systems. Later as a Patient Account Manager for St. Francis Medical Center in Pittsburgh, PA, where he improved collections to hit 95% rate through the implementation of new billing software and department reorganization.
Prior to working in the health and human services market, Mr. Wolfe spent five years practicing as a Lawyer with at Law Offices of Arch A. Moore in Moundsville, WV. In this role he provided general legal practice, created and established bylaws for multiple corporation, and handled West Virginia licensing of first vision insurance plan.
Mr. Wolfe earned his Juris Doctor from the West Virginia University School of Law in Morgantown, WV and his Bachelor’s degree with a focus in Political Science and Sociology from West Liberty University, in Wheeling, WV, where he graduated Magna Cum Laude.
Framework For Building A Workforce Strategy – Succeeding Amid A Workforce Shortage
Your workforce is your most important strategic asset and managing it is one of the most important competencies in the “next normal.” Prior to the pandemic we were contending with a workforce shortage, and now, it is even more of a challenge. Many would like to believe that throwing money at the problem might be the solution, but it’s much deeper than that. This session aims to examine both the framework for creating a strategy of growth in this area, while managing costs and finding alternative solutions for success. Hear how your organization can make it work through insights, strategy, and best practices for putting these ideas into motion. Expect to take away:
- Strategies for incorporating best practices in building your workforce
- Success stories and real-life examples you can take back to your organization
- Long-term solutions for recruitment and retainment challenges
Paul M. Duck
Paul M. Duck brings more than 40 years of experience in leadership and management focusing on managed care, health information technology organizations, strategy, business development, and market expansion, and customer experience optimization to the OPEN MINDS team.
Prior to joining OPEN MINDS, Mr. Duck served as the Vice President, Strategy & Development at Beacon Health Options. In this role, Mr. Duck led the organization’s strategy and business development efforts, which led to a 30% increase in net revenue and initiated more than $1 billion in revenue generation. Mr. Duck was active in national behavioral health initiatives as an executive of Beacon Health Options, including participating as a speaker at national and state association meetings.
Before joining Beacon Health Options, Mr. Duck was the Vice President of Business Development at Netsmart Technologies. During his tenure, Mr. Duck was responsible for business planning including the oversight of strategic activities including acquisitions, development, and execution of strategic initiatives, and positioning, and sales of large strategic customers. He also led the rollout of the company’s benchmarking and data analytics product suite.
Prior to Netsmart, Mr. Duck served as the Chief Executive Officer for Coastal Orthopedics and Pain Management, a large group practice with five clinic locations and two ambulatory surgical centers. As the organization’s chief executive officer, Mr. Duck was responsible for significant positive changes in leadership and corporate culture, financial and operational performance, compliance, and governance. Mr. Duck improved net collections by over $1 million per month and grew the practice through negotiating better contract rates with payers. He also implemented an organizational rebranding initiative and launched a new marketing campaign.
Prior to Coastal Orthopedics and Pain Management, Mr. Duck served as the President and Chief Executive Officer for Florida Radiology Imaging, one of the largest outpatient diagnostic imaging service companies serving the greater Orlando market. During his tenure, Mr. Duck led the construction of three new, full modality, diagnostic imaging locations. Mr. Duck revolutionized the company’s culture by creating a highly attractive and functional work environment.
Mr. Duck earned his Bachelor of Arts in Business Management from Case Western Reserve University. He earned his Associate of Arts in Electronic Engineering Technology from the Electronic Technology Institute. Mr. Duck received an award by Inc magazine for leading Florida Radiology Imaging as one of America’s fastest-growing companies. Mr. Duck recently served as a contributing author to the book The New Health Age: The Future of Health Care in America.
Kimberly Bond, MS
Kimberly Bond, MS, LMFT, brings more than 30 years of experience providing behavioral health treatment in the public and community settings to the OPEN MINDS team. She currently serves as the Executive Vice President of Business Development. In this role, Ms. Bond focuses on growing the OPEN MINDS client portfolio across all nine verticals of OPEN MINDS business.
Prior to joining OPEN MINDS, Ms. Bond served concurrently as a Program Coordinator III and Clinical Manager of Adult Services and a Program Coordinator II and Clinical Manager of Recovery Services for the Ozark Guidance Center. In these roles, Ms. Bond was responsible for the administrative and clinical oversight of the adult outpatient and adult intensive mental health services on the Springdale Campus as well as the adult recovery/co-occurring services, including domestic violence and anger management treatment.
Prior to joining the Ozark Guidance Center, Ms. Bond served as the Executive Vice President of Center Point, Inc, a large substance abuse provider agency in California. In this role, Ms. Bond was responsible for the clinical and administrative supervision of all community-based programs as well as the women and children residential programs. In addition, Ms. Bond also managed budgets, interacted with funding agencies, and built positive relationships with all stakeholders. Ms. Bond was also in charge of proposal and grant writing, staff management, and training, facilities’ licensing and certifications renewals. Additionally, she prepared and submitted monthly, quarterly, semi-annual, and annual reports to various funders.
Previously, Ms. Bond served as the President and CEO of Mental Health Systems, Inc. Ms. Bond was very instrumental in growing the agency from $12 million in annual revenue to more than $100 million and becoming one of the largest providers of behavioral health services in California. In this role, Ms. Bond was responsible for the strategic, clinical, financial, and administrative health of the agency, including direct supervision of Senior Executive Staff. In addition, Bond ensured contract compliance of the agency’s 125 different contracts across federal and state agencies and eight counties.
Ms. Bond received her bachelor’s degree in psychology, with honors, and her master’s degree in counseling education from San Diego State University. She is licensed as a Marriage and Family Therapist in both California and Arkansas.
How To Get Started (Or Expand) Delivering Home-Based Service Delivery
“Community-based care” has long been a buzz phrase in health and human services. The focused effort to move consumers in need of long-term services and supports (LTSS) into the community is working—and forcing the entire health care system to rethink what “community” means. For most consumer populations, the goal is to limit residential and inpatient services wherever possible and to focus care delivery on home- and community-based services (HCBS). But simply delivering services in the community isn't enough. To truly achieve community integration, provider organizations need to focus on consumer-centered care models and create a plan to help consumers participate in meaningful living situations, which may include employment, education, relationships, and leisure activities. In this session, we'll discuss how to build a consumer-focused care model for community integration and how your organization can get there. The session will cover:
- Current models and key elements of a community integration model of care
- Key challenges and best practices for specialty provider organizations in building a consumer-focused community-based program model
- Best practices for implementing and expanding into home-based service delivery
Troy Brindle
Achiever, Arranger, Influencer, Innovator, Relator, and Strategic Thought Leader.
Over 25 years experience in executive administration and direct clinical practice with children, adolescents, adults and older adults. Results oriented leader with a proven track record of organizational success across multiple systems including inpatient, partial hospitalization, residential treatment programs, outpatient behavioral health and integrated behavioral health programs. Recipient of the 2019 RCPA provider award for successfully integrating behavioral health services within medical settings for the Commonwealth of Pennsylvania.
Founded, designed, developed and administratively oversee the behavioral health integration services for over 78 Primary Care Physician and Medical Specialty Practice in southeastern, PA and NJ. Built key relationships with AdvoCare, Grandview Health System, Main Line Healthcare, and Penn Medicine to successfully integrated into primary care and medical specialty practices. In 2018, featured on the nationally syndicated "Informed Series" hosted by Rob Lowe for cutting edge work in behavioral health integration.
Experience in cognitive behavioral therapy, behavior activation, mindfulness, motivational interviewing, insight oriented therapy, problem solving therapy, and structural family therapy.
Also experienced in stress management, play therapy, behavioral therapy, parenting support, medical co-morbidities and hypnotherapy.
Experience with trauma, abuse and grief counseling.
Christian counseling and eating disorder sub-specialty.
Internet and technology addiction treatment experience.
Sex addiction treatment experience.
Advanced experience in mediation, parent coordination and court ordered counseling/reunification.
Professional speaking engagements at the local, state and national level.
Professional publications local, state, and national level.
Experience with television, radio, newspaper, and magazine interviews.
Adjunct Faculty Cairn University.
2015 received Cairn University's distinguished Alumni of the Year Award.
Carol Clayton, Ph.D.
Dr. Carol Clayton is a licensed, psychologist with 30 years of health care experience in the public and private sector, including non-profit and private practice work. Prior to joining OPEN MINDS as a Senior Consultant, she retired as the Translational Neuroscientist for Relias, where she specialized in health care solutions targeting workforce development and population health outcome improvement. Before joining Relias, Dr. Clayton was the CEO of Care Management Technologies, a health IT data analytics company. She also served as the Executive Director of the NC Council of Community Programs from 2000-2006. The NC Council is the predecessor organization to i2i.
Sharon Hicks
Sharon Hicks, OPEN MINDS Senior Associate, has more than 20 years of experience in the health and human service field. She has extensive experience and wide range of expertise in health plan management, in clinical operations management, and technology.
Prior to joining OPEN MINDS, Ms. Hicks spent two decades in a number of executive positions within the University of Pittsburgh Medical Center (UPMC) system and within its health plan division. Ms. Hicks served as the Chief Operating Officer for Community Care Behavioral Health, a managed behavioral health organization. There she was responsible for all aspects of the organization’s operations including fiscal, information systems, the claims processing department, and the design of clinical systems. In addition, Ms. Hicks managed the day-to-day operations of including human resources, facilities, purchasing, and security.
Ms. Hicks also served as the Vice President, Internet Strategy, UPMC Insurance Services Division and, since 2002, as the Chief Executive Officer of Askesis Development Group, Inc. In this role, Ms. Hicks was responsible for the growth of the company, profitability of the company, and the direction of software development.
Ms. Hicks started her impressive health care career as a psychiatric social worker before being promoted to Assistant Director of Social Work. Prior to her executive promotions, Ms. Hicks served as a Clinical Administrator for both Ambulatory Services and Emergency and Intake Services at the UPMC Western Psychiatric Institute and Clinic. In this role, she managed the behavioral health division, the budgets for all departments, and implemented new software replacing paper billing for clinical services.
Ms. Hicks received both her Masters of Business Administration and Masters of Social Work degrees from the University of Pittsburg. Before pursuing her graduate education, Ms. Hicks received her Bachelor’s Degree in Psychology.
Creativity In Contracts, Carve-outs, & Capitation
New payment models link health plan and provider organization reimbursement to value by incorporating cost, consumer health outcomes, and consumer experience into the payment equation. While this shift poses many obstacles in financing and operations for provider organizations, it also creates new challenges for clinical treatment models. In this discussion session, we’ll review how capitated contracting impacts clinical care, the ethical issues that accompany a move to capitation, and how clinicians can balance the needs of their consumers with the needs of their organization’s financing arrangements. We will also hear how organizations are utilizing innovative carve-outs to control costs in narrow networks and partnerships. After attending this session, you will be able to:
- Identify areas within your organization that could benefit from creative problem solving
- Utilize capitation, carve-outs, and contracts to better position your organization for market success
- Adopt strategies to take back to your organization to positively affect your bottom line
Heather TerHark-Monreal
Heather TerHark-Monreal has over 25 years of diverse continuum of care healthcare experience. Heather provides leadership and direction in ancillary support, business development for new projects in post-acute and senior living settings, managed care contracting, and transitional care oversight and guidance to Vivage/Wellage communities and Bridges Community Homecare, Hospice and Palliative Care. Heather develops key partnerships and strategic programming for innovations in a variety of care delivery models in regional and national markets.
Additionally, Heather has been an Assisted Living Executive Director and has directed large sales and marketing teams. Heather has experience in home care and hospice, having developed Medicare and private duty programs as well as geriatric case management. Heather obtained a bachelor’s degree in Business Administration with an emphasis on Healthcare Administration from Frederick Taylor University after attending Missouri State University, where she studied Recreation Leisure Studies with an emphasis on wellness.
Ray Wolfe, J.D.
Raymond “Ray” Wolfe, J.D. brings over 40 years of experience in the health and human services sector to the OPEN MINDS team. Mr. Wolfe currently serves as a Senior Associate, a position in which he utilizes his expertise to successfully lead varying projects for OPEN MINDS. His areas of expertise include financial analysis and management, mergers and acquisitions, performance improvement, and strategic planning.
Before joining OPEN MINDS, Mr. Wolfe served in a 22 year tenure with Pittsburgh Mercy Health System in Pittsburgh, Pennsylvania. Most recently, Mr. Wolfe served as the organization’s Chief Operating Officer (COO) where he was responsible for oversight of all system operations, strategic planning, and performance management. Under his direction Pittsburgh Mercy achieved over $850K in value-based reimbursement contract quality bonus awards, integrated three organizations through merger/acquisition, and adopted a new performance management program for managers.
Before acting as Pittsburgh Mercy’s COO, Mr. Wolfe served as the organization’s Chief Financial Officer (CFO) and was responsible for the development of internal costing methodologies, contract rate negotiations, and financial forecasting activities. In addition, he coordinated an integrated care program with local partner hospitals to develop a series of diversion and respite programs, as well as, specialized primary care, integrated care management and high utilizer teams, while maintaining 15 straight years profitability.
Mr. Wolfe was promoted to CFO after serving as the Director of Fiscal and Information Security/Compliance for the health system. In this role, he was responsible for managing the transition of service contracts from fee-for-service (FFS), leading all compliance activities, and implementing a next generation electronic health record (EHR) system.
Prior to his time at Pittsburgh Mercy Health System, Mr. Wolfe served as Chief Fiscal Officer with the Summit Center for Human Development in Clarksburg, West Virginia, where he was responsible for reporting and budgeting functions and preparing Summit Center’s programs for FFS billing.
Previously, Mr. Wolfe served in billing and collections for two Pennsylvania-based hospitals. First, as an Accounts Receivables Manager for Brownsville General Hospital in Brownsville, PA, where he managed the accounting and billing system transition systems. Later as a Patient Account Manager for St. Francis Medical Center in Pittsburgh, PA, where he improved collections to hit 95% rate through the implementation of new billing software and department reorganization.
Prior to working in the health and human services market, Mr. Wolfe spent five years practicing as a Lawyer with at Law Offices of Arch A. Moore in Moundsville, WV. In this role he provided general legal practice, created and established bylaws for multiple corporation, and handled West Virginia licensing of first vision insurance plan.
Mr. Wolfe earned his Juris Doctor from the West Virginia University School of Law in Morgantown, WV and his Bachelor’s degree with a focus in Political Science and Sociology from West Liberty University, in Wheeling, WV, where he graduated Magna Cum Laude.
Joseph P. Naughton-Travers, Ed.M.
Joseph P. Naughton-Travers, Ed.M., Senior Associate, has more than 30 years of experience in the health and human service field. In this tenure as senior associate with OPEN MINDS since 1998, he has served as lead of dozens of client initiatives, served as editor of OPEN MINDS publications, and is the author of many groundbreaking articles and presentations.
Mr. Naughton-Travers brings to OPEN MINDS a broad range of experiences in private and public sector delivery of behavioral health and social services. He started his career as a behavioral health clinician, working in both child welfare and community mental health clinic settings. Subsequently, Mr. Naughton-Travers held a senior business operations management position for a psychiatric hospital system and its community mental health clinics. Later, he was vice president of a firm specializing in information systems and billing and receivables management for community-based mental health programs.
Since joining OPEN MINDS, Mr. Naughton-Travers has developed business solutions for provider and professional organizations, state and county government, technology companies, and venture capital firms. His primary areas of expertise include strategic planning and metrics-based management, electronic health record (EHR) and technology selection and implementation, operations improvement, and corporate compliance. For the past decade, more than half of his consulting practice has focused on aiding organizations in technology selection and implementation, including all aspects of strategic technology planning, functional specifications development, request for proposal development, vendor selection, and contracting.
He has written numerous articles, including “Winning the Human Resource Wars: Tried, True and New Strategies for Behavioral Health and Social Service Organizations,” “Five Pillars of Management Competency,” “Data Driven Decision Making: Moving to an Organizational Measurement Culture,” “Survival of the Smartest: What is Your Organization’s Information Literacy IQ?,” and “Strategic Human Resource Management: Aligning Compensation with Employee Performance and Organizational Strategy.” Mr. Naughton-Travers is also a nationally recognized speaker, having conducted hundreds of executive and professional executive training events around the nation.
Mr. Naughton-Travers received his Bachelor’s degree from Miami University of Ohio and his Masters’ of Education in Counseling Psychology from Boston University.
Lunch On Your Own
Post Lunch Pick Me Up
Don’t miss out on our post-lunch pick me up networking opportunity today – enjoy seasonal flavored sweet & savory chef inspired popcorn with your colleagues in the exhibit hall before wrapping up the institute
Preparing For CalAIM: Performance Measurement & Performance Management Under CalAIM
The California Advancing and Innovating Medi-Cal (CalAIM) initiative will implement broad reforms to California’s Medicaid delivery system, programs, and payment methodologies. The policy goals of CalAIM are to reduce system complexity, increase flexibility, improve quality of care, and drive system transformation through the use of value-based initiatives, payment reform, and integrated approaches for behavioral health, addiction treatment, and primary care for complex populations. In the multi-year implementation, some of the provisions go live on January 1, 2022 including new contracts with specialty provider organizations to deliver Enhanced Case Management and Community Supports (In Lieu of Services) for adult SMI populations. The final provisions are projected to go live by 2027.
The big question is how will CalAIM change the measures of success? What performance measures will get the focus of counties, health plans, and provider organizations? This session will provide an overview of the likely changes in performance measure in Medi-Cal - and how specialty provider organizations and primary care organizations can prepare for new measures of value and new value-based initiatives.
This session will cover:
- Likely changes in the measurement of 'value' under CalAIM with possible new value-based reimbursement models and their metrics of success
- How specialty provider organizations and primary care organizations can build a metrics-based management system and culture for CalAIM success
- Case Study: Discovery Behavioral Health will share their examples of value-based contracts with health plans, metrics management and performance measurement strategies to achieve aligned payer-provider success
Alyson Albano, M.S., LMFT, PMH-C
Alyson Albano, M.S., LMFT, PMH-C, holds the role of Director of Clinical Quality for Discovery Behavioral Health. Serving over 15 years in behavioral healthcare, Alyson has experience in a wide range of levels of care, serving populations including, substance use disorders, eating disorders, gambling disorder, complex trauma, mental health disorders, and perinatal mood, and anxiety disorders. Alyson is a certified perinatal counselor and is certified in complex trauma and Telemental health.
Alyson’s professional focus includes implementation of evidence-based clinical documentation, standardization to achieve value-based care, implementation and tracking of validated instruments to produce clinical outcomes and introducing a suicide prevention best practice framework to strengthen access and delivery of suicide care, promote connectedness, and implement suicide risk mitigation strategies based on patient’s risk level. Additionally, focus has been placed on delivering innovative quality methods through training and documentation by overseeing the Center of Excellence scorecard, an internal tool, used to measure indices of progress throughout the organization, and most recently an opportunity to measure Value-Based Care. In late 2020, Alyson initiated a clinical philosophy, corresponding manual, The Clinician’s Desk Reference, and a supervision framework for Discovery Behavioral Health. This was a collaborative effort and developed with input from expert clinicians from all service lines within the organization.
Alexa Baghdassarian, M.S., LMFT
Alexa Baghdassarian, Licensed Marriage and Family Therapist, holds the role of Director of Utilization Review at Discovery Behavioral Health. Serving 8 years in behavioral healthcare, Alexa has experience in a wide range of levels of care, serving populations including Substance Use Disorders, Mental Health Disorders, and Eating Disorders. Alexa proactively works with the Clinical Services and Quality Management Department to implement high-quality evidence-based clinical processes to successfully align with payer-provider goals. Another priority for Alexa is to hold monthly meetings with managed care organizations to assure timely and appropriate interactions, to review outcomes, and to ensure there is alignment in processes and expectations.
Diane Sayegh, LCSW
Diane Sayegh, LCSW, holds the role of Director of Utilization Review for Discovery Behavioral Health. Diane has spent 8 years of providing direct patient care in the community mental health setting working with adults with severe mental illness and has extensive training documenting medical necessity. Diane’s professional focus includes interdepartmental utilization review training, medical necessity documentation training for all levels of care and identifying strategies to increase length of stay to support positive patient outcomes. Additionally, Diane has been focused on reducing barriers to patient care, hosting ATA blocking training for all clinical staff and working collaboratively with payers to discuss our organizational initiatives to support patient care, experience, and outcomes.
Richard Louis, III
Richard Louis, III has extensive experience as a behavioral healthcare administrator, business development specialist, and innovator of new service lines for behavioral healthcare organizations and currently serves the Vice President – Western Region at OPEN MINDS.
Previously, Mr. Louis was the Director of Development – Behavior & Addiction Medicine at Southern California Healthcare Systems Inc. / Prospect Medical. There, he was involved in many consulting projects focused on health care integration, developing new service lines, and health plan contract development. Most recently, 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. These solutions have shown to reduce payer spend while improving client outcomes for acute care hospital systems, health plans, managed care organizations (MCO), managed service organizations (MSO), managed behavioral healthcare organizations (MBHO), medical groups (IPA) and social service agencies.
Mr. Louis was also the Executive Director of Strategic Development and Planning at Pathways – Molina Healthcare, a national for-profit behavioral healthcare company operating 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 readmissions, emergency department (ED) visits, and improve HEDIS scores for national health plans and Managed Care Organizations.
Mr. Louis is also a former Psychiatric Hospital Administrator and Assistant Director of Mental Health for San Bernardino County Department of Behavioral Health in CA, where he was responsible for behavioral health program management, clinical operations, strategic alliances, and outcome-based service delivery models for complex adult and youth populations.
Mr. Louis also served in various positions at College Health Enterprises (CHE), a Los Angeles based for-profit hospital system, most notably serving as Vice President of Government Operations. While in this role, he created the first public sector division for CHE by establishing new service lines, contracts, and new profit/revenue streams. His responsibilities included business and program development as well as administration of inpatient, outpatient, and residential continuums of care for public payers (i.e. county mental health systems, state department of developmental disabilities, county jail, state prison, and federal government agencies).
Mr. Louis is in his 32nd year as an active duty reserve police officer (volunteer) currently holding the rank of Captain, City of Monterey Park Police Department in Los Angeles County. He has worked closely with police, county sheriff’s departments, and healthcare systems to educate and craft “treatment versus incarceration” collaborations promoting treatment and cost-effective crisis triage interventions for persons with mental illness.
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.
Best Practice Models For Meeting The Needs Of Aging Consumers With SMI
What happens when your behavioral health and mental health consumers start to age? The confluence of aging and mental health services is often a road sewn with conflicting waivers, a back-and-forth of what needs are most “pressing”—it can be rife with miscommunication and confusion. The needs of the aging consumer, that has also been navigating the mental and behavioral health systems, can feel overwhelming to both consumer and organizations alike. Complex older adults often end up in a congregate care setting that may or may not have a deeper understanding of the mental health needs someone with an SMI may have or may specialize in behavioral health but not understand how aging plays into this area. In this session we will examine some best practice models that are innovating in this area, and how they have managed to navigate the complexities of aging and serious mental illness. You can expect to learn:
- Specific needs and considerations for this population
- Strategies for incorporating these consumers into your area of service
- How other organizations are shifting their models of care to meet the needs of older and aging adults with serious mental illness
Sharon Hicks
Sharon Hicks, OPEN MINDS Senior Associate, has more than 20 years of experience in the health and human service field. She has extensive experience and wide range of expertise in health plan management, in clinical operations management, and technology.
Prior to joining OPEN MINDS, Ms. Hicks spent two decades in a number of executive positions within the University of Pittsburgh Medical Center (UPMC) system and within its health plan division. Ms. Hicks served as the Chief Operating Officer for Community Care Behavioral Health, a managed behavioral health organization. There she was responsible for all aspects of the organization’s operations including fiscal, information systems, the claims processing department, and the design of clinical systems. In addition, Ms. Hicks managed the day-to-day operations of including human resources, facilities, purchasing, and security.
Ms. Hicks also served as the Vice President, Internet Strategy, UPMC Insurance Services Division and, since 2002, as the Chief Executive Officer of Askesis Development Group, Inc. In this role, Ms. Hicks was responsible for the growth of the company, profitability of the company, and the direction of software development.
Ms. Hicks started her impressive health care career as a psychiatric social worker before being promoted to Assistant Director of Social Work. Prior to her executive promotions, Ms. Hicks served as a Clinical Administrator for both Ambulatory Services and Emergency and Intake Services at the UPMC Western Psychiatric Institute and Clinic. In this role, she managed the behavioral health division, the budgets for all departments, and implemented new software replacing paper billing for clinical services.
Ms. Hicks received both her Masters of Business Administration and Masters of Social Work degrees from the University of Pittsburg. Before pursuing her graduate education, Ms. Hicks received her Bachelor’s Degree in Psychology.
Carol Clayton, Ph.D.
Dr. Carol Clayton is a licensed, psychologist with 30 years of health care experience in the public and private sector, including non-profit and private practice work. Prior to joining OPEN MINDS as a Senior Consultant, she retired as the Translational Neuroscientist for Relias, where she specialized in health care solutions targeting workforce development and population health outcome improvement. Before joining Relias, Dr. Clayton was the CEO of Care Management Technologies, a health IT data analytics company. She also served as the Executive Director of the NC Council of Community Programs from 2000-2006. The NC Council is the predecessor organization to i2i.
Creating An Elastic Organization For Children’s Services
Children’s services are garnering more attention as we enter this phase of the “next normal” and we contend with a host of issues that we are just beginning to understand. That, coupled with a workforce shortage in health and human services makes for a perfect storm for organizations to be forced to find creative solutions to meet this quickly changing landscape. The demand for children’s services is an ever-changing numbers game, and your organization needs to be able to shift on a dime. But to do that, you need to have a strong foundation. This session will provide key elements on building an organization that can grow or shrink with shifting demand. We will provide the framework and hear from experts in this field, and then we invite you to join in a panel discussion with our presenters. You can expect to learn:
- The unique needs for children’s services in a post-pandemic world
- How to identify key elements that create an elastic organization
- The framework for positioning your organization for shifting demand
Amy Edgar
Amy Edgar, APRN, CRNP, FNP-C, is an inspiring nurse practitioner seeking to change healthcare from the inside and embrace the superpowers of our next generation of humans. Weaving the threads of mom, entrepreneur, teacher, nurse, primary care provider, and science geek, she founded the Children's Integrated Center for Success in 2014. Ignited by her experience raising her now 21-year old daughter, Amy unites systems thinking and integrated care delivery models to create a primary care center focused on children with behavioral health needs. From the latest in genetics research, to nutrition, to occupational therapy and speech, to art and equine therapy, to staffing school advocates and marriage counselors -- CICS strives to have the answers their families need to reach every child, every time. In 2017, Amy led CICS to better connect career opportunities for children with autism looking for suitable work to capture their own piece of the American Dream. This work pioneered the Remedy Foundation and CICS Maker Lab. In 2020 Amy converted CICS to a full service Virtual Care Company providing the same integrated care model in 5 states, with a strategic plan to scale to all 50.
In 2021 Amy joined forces with her business partner Dr. Matt Keener, to Co-Found Blackbird Health Inc. a technology enabled behavioral health service company. Blackbird Health will incorporate all of the learning and innovation from CICS to improve care and health for kids and families everywhere.
Elizabeth Saylor
As a fiscally meticulous, entrepreneurially minded Chief Executive Officer with a passion for positive change and technological innovation, Elizabeth Saylor has led the complete transformation of organizations, enabling them to thrive well beyond expectations. With vast expertise in billing, auditing, and reporting; revenue cycle management; and fundraising development and donations, Elizabeth Saylor has collected data to steer business improvements while growing both corporate enterprises and nonprofits.
Presently the CFO of Intermountain Deaconess Children’s Services, a nonprofit center providing mental health services for children, Elizabeth directs the finance, IT, quality assurance (QA), and operations departments. She established all accounting processes and controls, launched grant and purchasing departments, and advocated for the organization with legislatures.
James Stewart
James Stewart brings to OPEN MINDS more than 20 years of experience in the healthcare field. Mr. Stewart has helped develop and modify health care plans and benefits, retirement plans and benefits, and paid time off (PTO) plans for multiple behavioral healthcare providers. He has also had an integral role in program development and business planning for new strategic business lines. Additionally, he has led multiple teams in the selection, implementation, and use of multiple electronic health record (EHR) systems at several behavioral health care entities.
Mr. Stewart currently serves as the Chief Executive Officer at Grafton Integrated Health Network. He previously served as the Executive Vice President, Chief Administrative Officer, where he was responsible for the supervision of the Finance Departments, Contracting (both payer and vendor), Information Technology, Human Resources, Risk Management, Facilities Department, The Infant and Toddler Program, and the Education Department. He has participated and enabled the expansion of services through the acquisition of facilities and extension of the organization’s IT/HR network into Florida and West Virginia in the United States and also in Australia. Mr. Steward also spearheaded the process of developing and implementing a new paperless EHR, as well as a new accounting software that integrated with the electronic clinical record and billing system.
Prior to working at Grafton, Mr. Stewart was the Chief Financial Officer for the Center for Behavioral Health at Centerstone. In this position, he managed the coordination of a multi-disciplinary team through development and implementation of a Davies Award Winning Electronic Health Record. He developed new clinical programs to meet identified locality needs and established a merger between Non-Profit CMHC’s, which crossed state boundaries.
Mr. Stewart received his MBA with a Healthcare Administration focus from Indiana Wesleyan University. He received a Bachelor of Science degree in Accounting from the University of Kentucky.
Ken Carr
Ken Carr brings more than 20 years of finance, technology, data analysis, and reporting experience in the health and human services field to OPEN MINDS. He currently is a Senior Associate with the OPEN MINDS consulting practice. In this role, he has served as a subject matter expert leading numerous engagements in strategic planning, merger and acquisition prospecting, business process improvement, financial analysis of service lines, and technology selection.
Before joining the OPEN MINDS team, he served as the Chief Financial Officer of The Centers, a community mental health center in Ocala, Florida. In this position, Mr. Carr led a realignment of the organization’s financial management functions. This included revenue cycle management, EHR bill implementation and reporting, cash management enhancement, and strategic financial analysis.
Prior to his role at The Centers, Mr. Carr served as Chief Financial Officer of Guild Incorporated, an organization providing residential and community based mental health services in St. Paul, Minnesota. As CFO, Mr. Carr led the financial, billing, IT, quality, informatics, compliance, and facilities activities. During his tenure at Guild Incorporated, Mr. Carr used his expertise in change management and business process improvement to lead the EHR implementation team, align service data reporting and financial performance, and lead the financial and data capture activities for new service initiatives.
Mr. Carr has also held the positions of Administrative Director and Finance Director at the St. Paul National Testing Laboratory, a biomedical testing facility of the American Red Cross. In those positions he oversaw activities to enhance inventory management, align financial results to industry standards, and improve financial and facilities performance through problem analysis and quality management initiatives. He also was involved in directing human resource functions during laboratory closing near the end of his tenure.
Mr. Carr earned a Bachelor of Science in Business Administration from the University of South Dakota and a Master of Divinity Degree from Sioux Falls Seminary. He maintains an active CPA license with the State of South Dakota.
Raffle
With Performance Management, Timing Is Everything
“Strategy” is the big issue facing every executive team right now—and not just for executive teams in the health and human service field. The questions that health and human service executives are asking themselves is “Can our organization survive and thrive in the post-pandemic landscape? What are the market developments that will affect our revenue and our margins? What are the strategies that we need to adopt to stabilize our organization, to achieve our mission and objectives?"In her closing keynote, Monica E. Oss will discuss why performance matters (and it does!), and share how to position your organization in the market by becoming performance-focused, moving your organization into the "next normal."
Monica E. Oss
Monica E. Oss, M.S., Chief Executive Officer and Senior Associate, is the founder of OPEN MINDS. For the past three decades, Ms. Oss has led the OPEN MINDS team and its research on health and human service market trends and its national consulting practice. Ms. Oss is well known for her numerous books and articles focused on the strategic and marketing implications of the evolving health and human service field. She has unique expertise in payer financing models, provider rate setting, and service pricing. She has led numerous engagements with state Medicaid plans, county governments, private insurers, managed care programs, service provider organizations, technology vendors, neurotechnology, and pharmaceutical organizations, and investment banking firms – with a focus on the implications of financing changes on delivery system design.
The 2022 OPEN MINDS Health Plan Partnership Summit
Are strategic initiatives aligned for both health plans and provider organizations? Health plan priorities are being reshaped to meet new challenges of the changing health and human services landscape, and they’ve got “big data” behind their every move. For provider organization executives, understanding the dynamics of the health plans in their market is the key to creating preferred health plan relationships. During this one day event, we will hear from executives from health plans and provider organizations alike on specific case studies with regard to partnership opportunities. You will see how the right management tools, strategic insights, and the expert advice can help you navigate strategic health plan/provider partnerships in order to better serve consumers with complex support needs.
7:30 a.m. - 8:30 a.m. ET: Registration & Breakfast
8:30 a.m. - 9:00 a.m. ET: Welcoming & Introduction
Kickoff the Summit with co-chairs Cathy Gilbert, Senior Associate, and Richard Louis, III, Vice President, Western Region at OPEN MINDS presenting a high-level overview of health plan priorities in the “next normal”.
- Cathy Gilbert, Senior Associate, OPEN MINDS
- Richard Louis, III, Vice President, Western Region, OPEN MINDS
9:00 a.m. - 10:00 a.m. ET: If You Aren't Thinking About These Five Things... Start! Defining Performance Measures For Successful Payer/Provider Partnership
As provider organizations are implementing their 2022 strategy for sustainability post-pandemic, health plans are rethinking their market positioning with a new focus on payer – provider alignment. Health plans and providers can learn from each other so that shared consumers have positive outcomes, ensuring your organization remains sustainable and meets performance standards. Our speaker, as an executive in various Fortune 500, behavioral health payers, and government organizations, offers five things that 40 years of experience have proven are critical to improved performance, meeting objectives ,and building sustainable payer-provider partnerships.
• Culture trumps strategy every time…..pay as much attention to culture as a strategy
• Disruptive events/innovations drive change before you can plan for them
• Maintaining uncompromising integrity in data is critical to achieving outcomes
• Expectations unknown or not clear are doomed to create failure
• Building partnerships is a two-way journey to success
- Dennis Derr Ed.D., SPHR, MBHO/EAP Facilitator, National Behavioral Consortium
10:15 a.m. - 11:45 a.m. ET: Out of The Shadows: How Substance Use Disorder Has Helped Pave The Way For Partnership Opportunities
Over 70,000 Americans died in 2019 from an opioid overdose, and this number is estimated at over 90,000 for 2020, the highest it has ever been. How can providers work with health plans to ensure they offer the most up-to-date treatment (behavioral and medication assisted), while balancing quality care with improved and measurable consumer outcomes? Programs and facilities receiving distinction as a center for excellence must demonstrate coordinated multidisciplinary care plan for consumers, and must also provide timely access to quality medical and psychosocial care in all phased of treatment. The Blue Distinction Specialty Care program helps consumers find quality treatment and care in the area of substance use disorders. These nationally designated facilities must demonstrate a commitment to delivery improved consumer outcomes, and safety while demonstrating objective measures. Hear from one such provider organization who is doing exactly that, while working together within the Blue Distinction Program and the intricacies of navigating that partnership.
- Bill Pompos, Manager, Program Execution & Network Strategy, BCBS of MI, Behavioral Health Strategy & Planning
- Silvia Gramada, Manager, BCBS of MI, Behavioral Health Strategy & Planning
- Bruce Goldberg, President, River’s Bend PC
- Richard Louis, III, Vice President, Western Region, OPEN MINDS
- Cathy Gilbert, Senior Associate, OPEN MINDS
11:45 a.m. - 1:15 p.m. ET: Networking Lunch
1:15 p.m. - 2:45 p.m. ET: Looking For Quality Outcomes? It Starts With Innovative Value-Based Contracting
The shift away from traditional fee-for-service reimbursement models to value-based reimbursement (VBR) has turned “business as usual” on its head for many specialty provider organizations. It has forced executive teams to continue their current operations, while simultaneously implementing new services, technology, and data-driven systems that are necessary for VBR success. New or redesigned services linked to quality outcomes need to be built, negotiated, and piloted. Technology that drives outcomes and creates operational efficiencies needs to be identified, funded, and implemented. And, a culture of using data to ensure standardized, results-oriented outcomes across the organization must be built. Provider organizations need to move from an understanding of the key competencies required in the VBR model to tactical initiatives for implementing the talent, technology, and systems that deliver quality and value within value-based contracts.
- Monica Collins, Sr. Director, System Transformation, Magellan Behavioral Health of Pennsylvania
- Charlotte Chew, Vice President, Out Patient Operations, Pyramid Healthcare
- Richard Louis, III, Vice President, Western Region, OPEN MINDS
- Cathy Gilbert, Senior Associate, OPEN MINDS
3:00 p.m. - 4:15 p.m. ET: Simplifying Access To Behavioral Healthcare: New Directions Behavioral Health & Tridiuum Demonstrate Success With Florida-based Provider Program
New Directions Behavioral Health and Tridiuum launched their Florida-based provider program in December 2021. In this session, learn how advanced analytics and technology-enabled direct scheduling increases reach, improves member access and connection to quality behavioral healthcare.
- Mark Redlus, President, Tridiuum
Bruce Goldberg
Mr. Goldberg is the President and co-owner of River’s Bend PC He has been in practice for over 25 years and treats adolescents and adults for substance abuse and mental health within an individual, family and group treatment setting.
He provides Ambulatory Detoxification, Intervention Planning and Execution, as well as consulting for chemical dependence. Mr. Goldberg is an SAP (Substance Abuse Professional) and Health Professional Recovery Program (HPRP) provider. He co-facilitates the Adult Intensive Outpatient and facilitates the Adult Early Recovery Group.
Mr. Goldberg has presented for various cities to parents and leaders as well as statewide conferences to aid in educating within the field of substance abuse.
Bill Pompos
Manager, Program Execution & Network Strategy
Behavioral Health Strategy & Planning
Blue Cross Blue Shield of Michigan
Mr. Pompos has been with Blue Cross and Blue Shield of Michigan for over 10 years. In his current role, he manages clinical program development, provider network strategy, and the evaluation of new and existing programing. Bill collaborates with many internal and external partners to define and develop provider programs to fill gaps in care and acts as a liaison with operations teams in utilization and care management.
Bill has over 30 years of experience working in behavioral health as a therapist, clinical director, administrator of clinics, employee assistance programing, critical incident response team leader and managed behavioral healthcare.
Mr. Pompos earned his bachelor’s and master’s degree in social work from Michigan State University in East Lansing, MI. He is a licensed clinical and administrative social worker in the state of Michigan and a member of the Academy of Certified Social Workers.
Charlotte Chew
Service:
• Led initiatives to improve access to inpatient and outpatient services
• Developed a single point of access for patients, families, direct care providers, and the community at large
• Responsible for the team that reduced wait time to outpatient diagnostic and imaging services
• Provided consultative services to review staffing patterns and outpatient physician office improvements and efficiencies
Quality and Safety:
• Developed a county based quality improvement program in the area of Human Services
• Facilitated process improvement work groups to identify areas of opportunity and implement plans to insure future compliance.
• Used patient satisfaction results to design program modifications that led to improvement on patient outcomes post discharge
• Led a multidisciplinary team to reduce the number of patient restraints which also led to a decrease in employee injuries.
People:
• Employee engagement scores have been consistently high across all areas of responsibility
• Established a program and process for internship opportunities at various service levels that provided great training for students and an opportunity to access the skills and fit of potential future workforce.
Finance:
• Access efforts resulted in increased revenues
• Success in reviewing programs and staffing patterns to promote a positive contribution margin.
Growth:
• Started several new programs to enhance the continuum of care
• Responded to multiple requests for proposals to provide innovative services and/or services that improved access to the community
Dennis Derr Ed.D., SPHR
Dr. Derr is a recognized expert in organization leadership, workplace behavior, behavioral health, and healthcare benefits with over 40 years of experience. He is currently President of Integrated Human Solutions, a consulting consortium bringing together seasoned health and operational experts in behavioral health, organizational leadership, and resiliency . He serves as the MBHO Thought Leader Facilitator for the National Behavioral Consortium, a behavioral health non-profit association of Employee Assistance and Managed Behavioral Health innovators dedicated to improving employee wellbeing and setting the standards for workforce support.
Prior to forming Integrated Human Solutions, he served in executive roles at America’s top three health insurance companies’ Anthem BCBS Government Services, United Healthcare’s Optum behavioral health subsidiary, and Aetna. As the Staff VP for Anthem Behavioral Health’s Medicaid division, he oversaw BH service delivery for 19 state Medicaid contracts, improving metrics and outcomes. As Sr. VP with Optum Health he lead the development of Optum’s Global Wellbeing and health integration, As the Assistant VP of behavioral health at Aetna, he grew the global Employee Assistance and Behavioral Change programs, from covering 500,000 members to over 22 Million lives over a 5 year period. He led Aetna in becoming the first to successfully incorporate telephonic depression and alcohol SBIRT into all services and has presented and published globally on the use of SBIRT for Alcohol misuse. . He provided thought leadership consulting to one of Canada’s top 10 e-health companies for their award winning digital mental health tool.
Prior to joining Aetna, Dennis was a contracted government executive and project officer engaged to redesign and management of the behavioral workplace improvement effort at the United States Postal Service, covering over 800,000 employees. His leadership during 9-11, the USPS anthrax incident, and the devastating effects of hurricanes Katrina and Rita was recognized by the Secretary of Health and Human Services, the prestigious Carter Center in Atlanta and The Center for the Study of Traumatic Stress at the Uniformed Services University of the Armed Forces Health Sciences. He served as Global Director of Workplace Specialty Health Services at Mobil Oil, for 10 years and was EAP Director in the Bell System for Michigan Bell for 13 years. He has provided consulting regarding the impact of benefit change, workplace human behavior and organizational leadership to Global Fortune 500 companies and domestic and foreign government leaders globally
His publications have appeared in Journal of Addictions, Benefit News, Personnel Management Today, EAP Digest, EAP Exchange, Behavioral Health Management, Journal of Occupational Health & Safety, and The Journal of Employee Assistance, as well as numerous research and global conference proceedings. He is the co-author of two books, “ Personal Success in a Team Environment” and Building “Personal Resiliency; A Simple Book of Practice for Living a Life of Resiliency”.
Mark Redlus
Mark Redlus is the President of Tridiuum, a digital behavioral health ecosystem and network management partner that is bridging the gap between patients, payers, and providers to improve access and follow-up care for members in need. Mark came to Tridiuum as Senior Vice President of Innovation focused on commercializing nearly two decades of scientific research into the products Tridiuum offers today. He elevated to CEO in 2017. Mark is a visionary leader, having served as Chief Executive or an Executive team member in multiple companies ranging from small institutionally venture-backed start-ups to midsized enterprises across a variety of industries, including software, technology, healthcare, environmental, cleantech and energy.
Silvia Gramada
Ms. Silvia Gramada earned her bachelor’s degree in health services administration and a minor in psychology from University of Detroit Mercy in Detroit, MI. She has over 10 years of experience working in healthcare having worked in both the hospital and commercial health insurance settings.
Ms. Gramada has been with Blue Cross and Blue Shield of Michigan for almost 5 years. In her current role, she is responsible for project management and funding oversight of initiatives within the behavioral health workstream, development of internal communications, as well as supporting local expansion efforts of the Collaborative Care model and the Blue Distinction Specialty Care Substance Use Treatment and Recovery program. Ms. Gramada collaborates with internal and external partners to implement solutions, and act as a liaison between program owners, customer business units and contracting to support creation of reimbursement strategies and operational changes.
If you don’t feel this is sufficient here’s some additional background that you can pull from and incorporate.
- Worked at an inpatient acute care psychiatric hospital for almost 5 years prior to working at Blue Cross. In this role I was responsible for safeguarding patients’ rights guaranteed by the Michigan Mental Health Code through investigation of all grievances. Monitored and analyzed trends in complaints and developed mitigation strategies for quality assurance and appropriate service recovery. Collaborated with executive leadership and clinical staff to implement solutions, and to develop and update policies, procedures, and training that comply with CMS and regulatory body guidelines
- In my previous role at Blue Cross I was responsible for product and program management, and ongoing administration of the Alternative Network Solutions portfolio suite covering over 600K members. Collaborated with established internal and external partners to review issues and facilitate resolution, evaluate network adequacy for any changes, implement solutions, discuss enhancements to design and processes for ongoing improvement and management of solutions. One of the products I managed was the Blue Distinction Specialty Care Benefit Design and I supported development of Local Plan Criteria for Cardiac Care, Knee/Hip Replacement, and Spine Surgery.
- Enrolled in MBA program at Wayne State University in Detroit, MI
Cathy Gilbert
Healthcare executive with over twenty years experience in the health care industry including non-profit, government and private insurance with ten years progressively higher level experience in provider networks in behavioral health arena.
Richard Louis, III
Richard Louis, III has extensive experience as a behavioral healthcare administrator, business development specialist, and innovator of new service lines for behavioral healthcare organizations and currently serves the Vice President – Western Region at OPEN MINDS.
Previously, Mr. Louis was the Director of Development – Behavior & Addiction Medicine at Southern California Healthcare Systems Inc. / Prospect Medical. There, he was involved in many consulting projects focused on health care integration, developing new service lines, and health plan contract development. Most recently, 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. These solutions have shown to reduce payer spend while improving client outcomes for acute care hospital systems, health plans, managed care organizations (MCO), managed service organizations (MSO), managed behavioral healthcare organizations (MBHO), medical groups (IPA) and social service agencies.
Mr. Louis was also the Executive Director of Strategic Development and Planning at Pathways – Molina Healthcare, a national for-profit behavioral healthcare company operating 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 readmissions, emergency department (ED) visits, and improve HEDIS scores for national health plans and Managed Care Organizations.
Mr. Louis is also a former Psychiatric Hospital Administrator and Assistant Director of Mental Health for San Bernardino County Department of Behavioral Health in CA, where he was responsible for behavioral health program management, clinical operations, strategic alliances, and outcome-based service delivery models for complex adult and youth populations.
Mr. Louis also served in various positions at College Health Enterprises (CHE), a Los Angeles based for-profit hospital system, most notably serving as Vice President of Government Operations. While in this role, he created the first public sector division for CHE by establishing new service lines, contracts, and new profit/revenue streams. His responsibilities included business and program development as well as administration of inpatient, outpatient, and residential continuums of care for public payers (i.e. county mental health systems, state department of developmental disabilities, county jail, state prison, and federal government agencies).
Mr. Louis is in his 32nd year as an active duty reserve police officer (volunteer) currently holding the rank of Captain, City of Monterey Park Police Department in Los Angeles County. He has worked closely with police, county sheriff’s departments, and healthcare systems to educate and craft “treatment versus incarceration” collaborations promoting treatment and cost-effective crisis triage interventions for persons with mental illness.
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.
The 2022 OPEN MINDS CFO Summit
Strategic vision is now a key competency that CFOs of health and human services organizations need to have as their role continues to shift in the “next normal.” The relationship between CFOs and CEOs and the Clinical team is integral. This exclusive customized all-day event will break down the biggest trends happening in the financial world and help you apply them to your strategic organizational plan, C-suite leadership team, and your operational performance. This elite educational summit kicks off our year long CFO Consortium designed specifically for the executive and financial professionals of health and human service provider organizations. Join us as we cover such topics as “The Post Pandemic CFO”, “Expansion & Growth”, “Access to Capital”, and “Mergers & Acquisitions”. This all day event will provide case studies, experts in the field, interactive tools, key competencies, and insights needed to strategically position your organization for ongoing financial success, sustainability, and competitive edge in today's changing health and human services environment.
7:30 a.m. - 8:30 a.m. ET: Registration & Breakfast
8:30 a.m. - 10:00 a.m. ET: The Post-Pandemic CFO - Navigating The Pandemic & Reorganizing For The Next Normal
The role of the CFO is changing. In a modern organization, strategic planning is at the top of hierarchy of needs, while administrative tasks are now rote. With this new face of the CFO as change agent, and strategic leader, emerges. As the CFO aligns with the CEO, this leadership duo is able to identify, model, and assess opportunities. This shift in structure of the organization and utilizing the fiscal department as a catalyst for change will position your organization for successful sustainability.
- Jeff Arledge, Executive Vice President, Chief Financial Officer, Easter Seals, Midwest
- Kevin Light, Chief Financial Officer, Diversus Health
- Ken Carr, Senior Associate, OPEN MINDS
10:15 a.m. - 11:45 a.m. ET: Planning For Growth - Financial Management Of New Revenue, New Contracts, & New Service Lines
Is your organization positioned to grow, especially given all the challenges we have faced in the past couple of years? It can be daunting to think about expanding in a time when many specialty provider organizations have been operating under a state of flux, but understanding your market position, and strategizing where your organization falls on the road to sustainability is a necessity. Identifying resources, examining service line development (or cuts), assessing financial feasibility of expansion all becomes necessary. The fiscal C-suite must understand the business models for growth and be able to financially project and operationalize the plans.
- Mary Ann Kowalonek, Vice President, Chief Financial Officer, SAM, Inc.
- James Stewart, President & CEO, Grafton Integrated Health Network & Advisory Board Member, OPEN MINDS
- Ken Carr, Senior Associate, OPEN MINDS
11:45 a.m. - 1:15 p.m. ET: Lunch & Networking - Sponsored by NextGen Healthcare
1:15 p.m. - 2:45 p.m. ET: Assuring Access To Capital - How To Finance Growth
Once your strategic plan is in place, what are the opportunities to access capital to grow your organization? The nuts and bolts of how you are going to grow, and knowing your return on investments, rate of return, case rates, unit-based costing, and KPIs will all inform how you will actually be able to make things happen. There are multiple options on how to access capital for both non-profits, and for-profit organizations, if you know where to look. Whether you are utilizing fundraising campaigns, REITs, forming mergers, or going after equity capital – you have to know the marketing needs, and make the financial case in order to move forward. Keeping your organization competitive within the health and human services market allows for innovative program development, and the ability to operate from a place of planning and growth
- Stephen DaRe, Chief Financial Officer, Chimes International Limited
- Ken Carr, Senior Associate, OPEN MINDS
- Ray Wolfe, Senior Associate, OPEN MINDS
3:00 p.m. - 4:30 p.m. ET: Big Enough To Compete? How CFOs Answer That Strategic Question
You can have internal organic growth, and you gain scale via mergers, acquisitions, or affiliation/partnerships. It is up to you to determine which gives your organization competitive advantage for optimal growth. Economies of scale and organizational size are an integral part of strategy for health and human service organizations. The question – how to develop a merger and acquisition implementation plan (or create strategic affiliations) that makes your organizational strategy successful? We will discuss how to position your organization to overcome the challenges of navigating the world of mergers, and acquisitions, while creating mutually beneficial partnership and hear from executives who will discuss both best practice and making that best practice work.
- Ken Carr, Senior Associate, OPEN MINDS
Kevin Light
Kevin Light oversees the Financial Operations at Diversus Health and in his leadership capacity, provides timely and accurate financial information to guide the company’s financial strategy and positioning. Additionally, Mr. Light’s responsibilities include the protection of Diversus Health assets and allocating appropriate resources to meet the Diversus Health Mission, Vision, and Strategic Initiatives. Mr. Light has been with the company for over 14 years and was drawn to not-for-profit work that supports a strong mission. Being presented with an opportunity to help people positively change their lives was a motivating factor when he joined the organization, and this passion still drives his work today. Mr. Light completed his graduate coursework in Database Designs in 2003 and a Bachelor of Science in Accounting and Finance in 1991 from the University of Colorado - Colorado Springs. He enjoys golf, fishing and being in the mountains during his spare time.
Jeff Arledge
Strategic finance and operational executive with a passion for continuous improvement, empowering highly functional teams, and leading transformational change. Proven success engineering the financial turnaround of businesses while driving cultural change toward an accountable, metrics driven environment, to ensure sustainability. Throughout his career he spearheaded several multi-million dollar technology infrastructure implementation projects that provided cost improvements, operational efficiencies and enhanced bottom line profitability.
His professional career spans both healthcare and the financial services industry, with additional strengths in strategic planning, financial planning & analysis, process improvement, operations, and information technology. His professional credentials include the Chartered Financial Analyst® designation and the Certified Healthcare Financial Professional certification from the Healthcare Financial Management Association.
Currently, as Executive Vice President and Chief Financial Officer for Easterseals Midwest, Jeff leads the strategic initiatives for the organization as well as finance, accounting, revenue cycle, information technology, risk management, compliance, contracting/legal, fleet management, and facilities management. Since joining ESMW in April of 2018, Jeff has led the transformational turnaround of the organization into a financially sustainable agency well positioned for future growth. A few of the current strategic initiatives include workforce management, new technology enabled supports delivery models, and various productivity enhancement initiatives.
Mary Ann Kowalonek , MSL, CPA, CGMA
Mary Ann is the Vice-President and Chief Financial Officer at Service Access & Management, Inc., a NACM Charter Member organization. SAM, Inc. is a human service organization serving over 25,000 individuals in 60 counties in the state of Pennsylvania. She is a Pennsylvania State University graduate, where she earned a Bachelor’s Degree in Accounting, and she is currently a Certified Public Accountant and Chartered Global Management Accountant. Additionally, she earned her Masters of Science Degree in Leadership.
Mary Ann has over 35 years of progressive management experience in not-for-profit, financial services, administration, and public accounting sectors. Her areas of expertise include organizational leadership strategies, strategic planning, financial analysis, and financial reporting. Mary Ann joined the NACM board in 2012 and currently serves as the Association’s Treasurer.
Stephen DaRe
Stephen DaRe is the Chief Financial Officer (CFO) for Chimes, bringing more than 25 years of specialty and managed healthcare finance and operations experience to the team. Prior to joining Chimes, Steve held the CFO role at Emergency Medical Associates (part of Alteon Health) and MEP Health (part of US Acute Care Associates.)
Earlier in his career he served as the senior vice president of finance at APS Healthcare, a behavioral health, disease management and specialty managed care company; was CFO of American Psych Systems, a behavioral health management company; and was a divisional CFO at Magellan Health Services, where he had overall financial responsibility for the public sector (State Medicaid/Tricare) division and acquisition integration activities for the Merit Behavioral and CMG Health purchases.
He holds an MBA from Loyola College and a bachelor’s degree in finance from the University of Baltimore.
James Stewart
James Stewart brings to OPEN MINDS more than 20 years of experience in the healthcare field. Mr. Stewart has helped develop and modify health care plans and benefits, retirement plans and benefits, and paid time off (PTO) plans for multiple behavioral healthcare providers. He has also had an integral role in program development and business planning for new strategic business lines. Additionally, he has led multiple teams in the selection, implementation, and use of multiple electronic health record (EHR) systems at several behavioral health care entities.
Mr. Stewart currently serves as the Chief Executive Officer at Grafton Integrated Health Network. He previously served as the Executive Vice President, Chief Administrative Officer, where he was responsible for the supervision of the Finance Departments, Contracting (both payer and vendor), Information Technology, Human Resources, Risk Management, Facilities Department, The Infant and Toddler Program, and the Education Department. He has participated and enabled the expansion of services through the acquisition of facilities and extension of the organization’s IT/HR network into Florida and West Virginia in the United States and also in Australia. Mr. Steward also spearheaded the process of developing and implementing a new paperless EHR, as well as a new accounting software that integrated with the electronic clinical record and billing system.
Prior to working at Grafton, Mr. Stewart was the Chief Financial Officer for the Center for Behavioral Health at Centerstone. In this position, he managed the coordination of a multi-disciplinary team through development and implementation of a Davies Award Winning Electronic Health Record. He developed new clinical programs to meet identified locality needs and established a merger between Non-Profit CMHC’s, which crossed state boundaries.
Mr. Stewart received his MBA with a Healthcare Administration focus from Indiana Wesleyan University. He received a Bachelor of Science degree in Accounting from the University of Kentucky.
Ken Carr
Ken Carr brings more than 20 years of finance, technology, data analysis, and reporting experience in the health and human services field to OPEN MINDS. He currently is a Senior Associate with the OPEN MINDS consulting practice. In this role, he has served as a subject matter expert leading numerous engagements in strategic planning, merger and acquisition prospecting, business process improvement, financial analysis of service lines, and technology selection.
Before joining the OPEN MINDS team, he served as the Chief Financial Officer of The Centers, a community mental health center in Ocala, Florida. In this position, Mr. Carr led a realignment of the organization’s financial management functions. This included revenue cycle management, EHR bill implementation and reporting, cash management enhancement, and strategic financial analysis.
Prior to his role at The Centers, Mr. Carr served as Chief Financial Officer of Guild Incorporated, an organization providing residential and community based mental health services in St. Paul, Minnesota. As CFO, Mr. Carr led the financial, billing, IT, quality, informatics, compliance, and facilities activities. During his tenure at Guild Incorporated, Mr. Carr used his expertise in change management and business process improvement to lead the EHR implementation team, align service data reporting and financial performance, and lead the financial and data capture activities for new service initiatives.
Mr. Carr has also held the positions of Administrative Director and Finance Director at the St. Paul National Testing Laboratory, a biomedical testing facility of the American Red Cross. In those positions he oversaw activities to enhance inventory management, align financial results to industry standards, and improve financial and facilities performance through problem analysis and quality management initiatives. He also was involved in directing human resource functions during laboratory closing near the end of his tenure.
Mr. Carr earned a Bachelor of Science in Business Administration from the University of South Dakota and a Master of Divinity Degree from Sioux Falls Seminary. He maintains an active CPA license with the State of South Dakota.
Ray Wolfe, J.D.
Raymond “Ray” Wolfe, J.D. brings over 40 years of experience in the health and human services sector to the OPEN MINDS team. Mr. Wolfe currently serves as a Senior Associate, a position in which he utilizes his expertise to successfully lead varying projects for OPEN MINDS. His areas of expertise include financial analysis and management, mergers and acquisitions, performance improvement, and strategic planning.
Before joining OPEN MINDS, Mr. Wolfe served in a 22 year tenure with Pittsburgh Mercy Health System in Pittsburgh, Pennsylvania. Most recently, Mr. Wolfe served as the organization’s Chief Operating Officer (COO) where he was responsible for oversight of all system operations, strategic planning, and performance management. Under his direction Pittsburgh Mercy achieved over $850K in value-based reimbursement contract quality bonus awards, integrated three organizations through merger/acquisition, and adopted a new performance management program for managers.
Before acting as Pittsburgh Mercy’s COO, Mr. Wolfe served as the organization’s Chief Financial Officer (CFO) and was responsible for the development of internal costing methodologies, contract rate negotiations, and financial forecasting activities. In addition, he coordinated an integrated care program with local partner hospitals to develop a series of diversion and respite programs, as well as, specialized primary care, integrated care management and high utilizer teams, while maintaining 15 straight years profitability.
Mr. Wolfe was promoted to CFO after serving as the Director of Fiscal and Information Security/Compliance for the health system. In this role, he was responsible for managing the transition of service contracts from fee-for-service (FFS), leading all compliance activities, and implementing a next generation electronic health record (EHR) system.
Prior to his time at Pittsburgh Mercy Health System, Mr. Wolfe served as Chief Fiscal Officer with the Summit Center for Human Development in Clarksburg, West Virginia, where he was responsible for reporting and budgeting functions and preparing Summit Center’s programs for FFS billing.
Previously, Mr. Wolfe served in billing and collections for two Pennsylvania-based hospitals. First, as an Accounts Receivables Manager for Brownsville General Hospital in Brownsville, PA, where he managed the accounting and billing system transition systems. Later as a Patient Account Manager for St. Francis Medical Center in Pittsburgh, PA, where he improved collections to hit 95% rate through the implementation of new billing software and department reorganization.
Prior to working in the health and human services market, Mr. Wolfe spent five years practicing as a Lawyer with at Law Offices of Arch A. Moore in Moundsville, WV. In this role he provided general legal practice, created and established bylaws for multiple corporation, and handled West Virginia licensing of first vision insurance plan.
Mr. Wolfe earned his Juris Doctor from the West Virginia University School of Law in Morgantown, WV and his Bachelor’s degree with a focus in Political Science and Sociology from West Liberty University, in Wheeling, WV, where he graduated Magna Cum Laude.
Maximizing Revenue, Aligning Internal Growth Strategy & Succeeding In Value-Based Care: An OPEN MINDS Executive Seminar on Marketing Strategy
Marketing is an invaluable tool for success and sustainability. Our essential and proprietary marketing planning process gives you the strategy and tools needed to compete. Having your sales and marketing team and your marketing plan aligned with your strategy for growth amidst a shift into value-based reimbursement is necessary. This "can't miss" half day opportunity provides your executive team with the skills to create a marketing plan that is solid, but flexible enough to grow your best practice competencies and position your organization with a competitive advantage in an ever-shifting marketplace. This is the only marketing seminar of its kind and is designed specifically for specialty provider organizations in the health and human services field. In this session you will:
- Learn the components to developing a marketing budget, including revenue forecasting, expense budgets, and return on investment
- Step by step process for creating a successful marketing plan and how to implement it
- Gain insights and access to signature marketing planning process and tools
This Executive Seminar will be presented virtually February 10th, from 1:00 p.m. – 4:30 p.m. ET
Timothy Snyder, Jr.
Timothy G. Snyder, Jr. brings a unique combination of marketing, business development, and online media expertise to OPEN MINDS. Since joining our team in 2008, Mr. Snyder has led over twenty strategic marketing and sales-focused projects, including comprehensive product launch initiatives, corporate re-branding/positioning projects, and website/online marketing programs for some of the largest and most influential pharmaceutical and technology organizations in the industry. In addition to his work in the consulting practice, Mr. Snyder currently oversees the marketing, public relations, and sales divisions of OPEN MINDS.
Prior to his current position, Mr. Snyder served as OPEN MINDS Vice President Of Marketing. During this time he was led the successful launch of multiple new product offerings, the re-design of the OPEN MINDS website, and the launch of PsychU.org – a free online community and resource center for professionals in the mental health community.
Mr. Snyder is a 2008 graduate of the AACSB Internationally accredited John L. Grove College of Business at Shippensburg University of Pennsylvania, where he earned a Bachelor’s Degree in both Marketing Communications and Business Management.
Casey Zanetti
Casey Zanetti brings more than 15 years of experience in marketing strategy, brand development, product launch, and customer success to the OPEN MINDS team. She currently serves as a Senior Associate in the OPEN MINDS consulting practice.
Prior to her position at OPEN MINDS, Ms. Zanetti served as the Founder and Senior Marketing Consultant at Zane Group. During her time at the Zane Group, Ms. Zanetti worked with entrepreneurs and established organizations to develop and execute strategic marketing plans that were data-driven and provided meaningful results.
Prior to her role at the Zane Group, Ms. Zanetti served as the Vice President of Marketing at Twistle. In this role, Ms. Zanetti developed a strategic plan to grow revenue by 100% in 2020. In addition, she developed an inbound and outbound marketing plan to build brand awareness, articulate value proposition, and generate qualified leads. Ms. Zanetti also defined Twistle’s key differentiators in the market based on competitive landscape, value proposition, key personas, and mission/vision/values.
Prior to her role at Twistle, Ms. Zanetti served as Vice President of Marketing for InDemand Interpreting. Ms. Zanetti established the marketing arm of InDemand and built a successful marketing and sales development team to execute a strategy that supported a CAGR of ~40% YoY. She built a premium brand by aligning InDemand’s offering with relevant industry trends to solve pain points and support thought leadership. She also developed the 5-to-Thrive program to support a seamless customer journey across the organization and positioned InDemand as a thought leader in the health care industry.
Prior to her role at InDemand Interpreting, Ms. Zanetti served as Director of Marketing for Apex Learning. She created aggressive revenue growth and initiated a social media strategy to support the sales organization and connect with previously overlooked stakeholders and influencers to increase sales.
Ms. Zanetti received her Bachelor of Arts, focused on International Marketing, from Western Washington University. In addition, she received her Master of Arts, Whole Systems Design, from Antioch University. She holds certificates in Digital Marketing, Executive Leadership, and Graphic Design.
