The Recovery Executive Podcast

Teen treatment has been a hot topic for expansion and investment recently in behavioral health. "Lots of demand with not enough providers" is the current mantra. But is this accurate? What makes a good teen health provider? Should adult programs add on teen options? If the prevailing mantra is true, why are we seeing so many closures of teen facilities across the country? All these questions and more will be answered with my guest, Chris Perkins, CEO of Velocity Health Group and previous CEO of Calo (now part of Embark), one of the most successful teen treatment programs in the country.

Many OON providers don't realize that a number of employer-funded insurance contracts include clauses that provide for higher reimbursements in exchange for guarantees not to balance bill patients, often resulting in millions of dollars of unreimbursed care. This episode is a deep dive into the complex world of third-party administrators (TPAs), downline administrators, self-funded vs. provider-funded insurance plans, and negotiating no balance billing clauses for OON contracts with Ali Beheshti, CEO of Zealie.

High-end private pay programs charge as much as $100,000 a month for patients entering these exclusive facilities. Cultivating referral relationships for patients in the income bracket that can afford such programs require a specialized approach. Mark O'Connor has worked in outreach for both Caron and The Lighthouse, two programs renowned for the quality of care they provide, that comes at significant cost for their higher end programming. Mark walks us through his relationships and approach that have helped him regularly place patients into such programming.

Stagnant community outreach and business development strategies are still the norm in much of the field of behavioral health, which is why so many providers struggle to build consistently high-performing teams. Often, lack of results is ascribed to the outreach reps themselves, but the reality is that there is significant opportunity for providers to step up their hiring, training, and support processes for their teams. Shelley Plemons, most recently the Senior Vice President of Strategy and Growth for Discovery Behavioral and now a Senior Consultant for Circle Social, discusses the strategies and tactics that define successful outreach teams. We discuss how much of it is really common sense, but this is certainly a topic where the adage "common sense is often not common practice" applies.

Intakes for psych hospitals are complex. Due to EMTALA, hospitals are required to serve anyone that meets criteria, but, if the only patients showing up to your door are ones that have no insurance and can't pay, your hospital will quickly close, which helps no one. So how do acute care facilities manage their marketing, outreach, and intake so that they are able to achieve their goals of being a good community partner, serving patients in need, and also surviving financially? To answer this question, I speak with Lance Folske, who has run psych hospitals and multisite operations for 2 decades. We discuss the right marketing channels, how to think about community outreach, and how to manage intake to successfully meet the 3 goals above.

Groups Recover Together has developed a very specific care model that doesn't fit into standard fee-for-service arrangements. This required them to think outside the box when negotiating with payers, resulting in the majority of their contracts being value-based care arrangements. Groups is committed to delivering positive outcomes for its patients and goes at risk with the payers to guarantee those results. They've developed robust outcomes tracking, something notoriously hard to do in the MAT space, enabling them to see what's working, what's not, and where taking risk is appropriate. Cooper Zelnick, CRO of Groups, walks us through their care model, the data they collect, and how both those things create value for patients and payers.

Intentionality is different from desire. Many programs want to grow, they strive to grow, but there is not always intentionality as to how they go about that, especially when it comes to community need and program design. In this episode, I speak with Jamie Vinck, CEO of Recovery Ways and former CEO of Sierra Tuscon, regarding building a program with intentionality. How should programs look at community need, payer relationships, and program development BEFORE they open up a new program? Jamie shares her extensive experience as well as Recovery Ways' current common sense strategy to growth and scale.

Successful call center operations are integral to the success of any provider. Your marketing and outreach teams can be phenomenal, but if your admissions staff on the phones don't do their job well, patients will go elsewhere. Call centers are so much more than merely staff training. The staff have to be good, but you also need to set them up for success with appropriate technology, tracking, software, scheduling, and structure. In this episode, Michele Santagata, CEO of Santagata Consulting, shares her expertise running call centers big and small for behavioral health.

How does a first-time entrepreneur bootstrap a treatment program starting with outpatient and then gradually building a full continuum of care? In Arizona, many treatment programs were started, and almost as many failed within short order, Tyler Tisdale, CEO of Pinnacle Peak Recovery, shares his story of success and what it took to get there, how he succeeded where so many others did not. He takes us through the pivots, systems, processes, and strategies that have made Pinnacle Peak one of the leading providers in the Greater Phoenix area.

AI, call flows, tech stack, and intelligent routing, all to improve call center conversions, decrease staff burnout, and reduce patient frustration on admissions calls. We'll talk about all that and more with Karl Fischer, Managing Director of DecisivEdge.

Everyone wants to know, "How do we get the best reimbursement rates possible?" Stu Segal, Principal at FlormanTannen, and I discuss this question in depth. Obtaining better reimbursement rates requires far more than asking for them or "hard-nosed negotiation." Instead, it requires planning, patience, outcomes data, and relationships, all integral pieces of successful negotiation with payers.

Through focused training and ongoing feedback, therapists can significantly improve their intervention skills in order to achieve stronger patient outcomes. With the payers focused on outcomes more than ever, the time is now to hone in on ways to strengthen clinical delivery. Zac Imel, Chief Science Officer of Lyssn and Professor in Psychology. speaks with me on the research regarding therapeutic skills and fidelity in clinical delivery. We talk about specific skills and actions therapists can take that help them become better therapists and help patients obtain better outcomes through the therapy received.

Payer expectations continue to change every year and so provider RCM benchmarks and best practices need to change as well. We're seeing more payers deny contracts or opt to not renew contracts based on a variety of trends in SUD. In this episode, I speak with Erin Burke, CEO of Hansei Solutions. With over 1 million processed claims from providers across the country, they have a ton of data to inform strategies for sustainable operations and strong payer relations.

Building the backend data infrastructure to track both business metrics and clinical outcomes is costly and time-intensive. Even for a medium-sized organization, this can cost upwards of $500,000 per year, so the last thing anyone wants to do is build it wrong or get off on the wrong foot. Dr. Nick Hayes, Chief Science Officer at Cumberland Heights, walks us through their best-in-class data science department. He and his team built out what I consider to be the best setup in the field. Nick shares how they built it, what that setup looks like, the outcomes they've gotten, and how it's helped Cumberland improve as an organization overall and deliver even better outcomes for patients.

As more programs implement patient outcomes tracking, it's become clear that care delivery becomes more effective when tailored. Some programs may be excellent with veterans while another may do better with something as specific as women using heroin over 40. Efficacy in delivery changes by demographic, geographic location, and even individual clinician delivering programming. In this episode, I speak with Eric Gremminger, CEO of ERP Health. We take a look at how providers are starting to implement outcomes tracking and the changes they're able to make as a result to improve results for patients.

The delivery of group therapy hasn't received an update or serious attention since Irvin Yalom's work back in the 50's. Because most therapy delivered in addiction treatment is group therapy and, as a field, we're finally talking about trackable outcomes, it has become clear that improved techniques are needed. Andrew Bordt, Executive Director for The Institute for the Advancement of Group Therapy, and I walk through the neurobiology of learning and how effective group facilitation can significantly improve outcomes not just in the group, but beyond as patients reintegrate into their daily lives.

There are many opportunities for payers and providers to work together in order to improve care and reduce barriers to treatment. In this episode, Debra Nussbaum, Senior Director of Behavioral Health at Optum, provides insights into what she looks for when partnering with a provider. She also explains what not to do and gives us a look at Optum's new provider portal to expedite UR. If your program has in-network contracts, you won't want to miss this episode.

Through the integration of digital and peer recovery supports, JourneyPure was able to double improvement of recovery outcomes compared to treatment as usual. In this interview, Dr. Brian Wind, Chief Clinical Officer of Regard Recovery and JourneyPure, shares how the integration of these supports came about, what results they've seen, and the success they've had in getting reimbursed for those efforts as well.

Specialty tracks are springing up all over these days, the most common being veterans, first responders, and LGBTQ. Some providers have also embarked on specific faith-based tracks, but these programs are not easy to do well. In this episode, I speak with Devora Shabtai, VP of Clinical Development for Onward Living. Having built both Christian-specific and Jewish-specific tracks at different providers, she walks us through the logistics and complexities of faith-based programming to help providers do it right.

Bringing a company out of bankruptcy is hard. Taking over marketing for an acquisition that's bringing in far less revenue than you thought it was is also very hard. Former CMO of both Foundations and Promises, Kathy Frossard, walks us through lessons learned through two large acquisitions. In particular, we discuss the viability of a national brand play in commercial SUD and why no one to date has been able to successfully accomplish it, though many have, and are, trying. We then discuss our thoughts on what to do differently in order to make that happen.

We've seen a tragic record of over 100,000 overdoses in the US last year. The common narrative is that overzealous marketing by pharmaceutical companies and overprescribing of opioids by medical professionals created a new wave of individuals addicted to pills that then turned to heroin when the pill supply dried up. However, according to SAMHSA's data, rates of addiction in the general population didn't change at all. So, while overdoses have skyrocketed, the percentage of the population struggling with addiction has not, meaning that the data doesn't exactly match the common narrative. Dr. Singer is a physician and owner of a group surgical practice who has also become a Senior Fellow at The CATO Institute, advising on opioids, drug policy, and other topics. In this interview, he walks us through a lot of the data from SAMHSA, NIH, and other research to help us take another look at what's happening in our country around drug use and overdoses. It's an episode you won't want to miss.

50 years of research has confirmed contingency management as one of the most effective treatment modalities out there both as a standalone and in conjunction with 12-step, community reinforcement approaches, and others. Yet, it's hard to find funding or reimbursement for it and most providers haven't even considered integrating it into their programs. In this episode, I speak with Eric Gastfriend, CEO of DynamiCare Health, a digital therapeutic platform with contingency management at its core. We talk about the research, the challenges to implementation, and what the academic literature says about doing it right.

​The MAT space has traditionally done very little in the way of marketing due to how underdeveloped the space is as well as the high demand for services from Medicaid patients. But, like addiction treatment and psych hospitals before them, as more and more providers have entered the space in a maturing market, reliance on being the only provider in town is no longer a viable strategy. BrightView is far ahead of what were once many of its much larger competitors because they started marketing back in 2019 before any MAT providers were doing so. Colin Jeffries, VP of Marketing, gives us insights into their reasoning and strategy in this episode of the Recovery Executive Podcast.

Conversations around diversity, equity, and inclusion in behavioral health are just beginning, so many providers don't know where to start. Or maybe they get started with a DEI statement, but are unsure where to go next. To make matters more complicated, DEI as a field is in its infancy and many DEI initiatives and practitioners offer little more than window dressing, lacking organizational alignment, KPIs, or tangible outcomes that executive teams can realistically support for the long-term. In this episode, I interview Zina Navarro-Rodriguez, owner of Z&D Consulting. Like me, she is a Certified Diversity Executive (CDE). We answer questions such as: - What should DEI look like in behavioral health? - How do we effectively engage different communities, both those struggling with addiction and those looking to work in the field? - What's the role of straight white men in DEI? - Why does DEI need to align with pre-established core organizational objectives rather than operating under its own agenda? - Do we really need unconscious bias training? It's a great discussion. Enjoy.

We end up exploring two topics in this interview with JD Kalmenson, CEO of Montare Behavioral Health: 1) How can screens help tailor treatment programming? 2) How can therapies such as TMS, Neurofeedback, or Ketamine be used in a continuum of care?

This is one of my favorite interviews to date. How did a little-known provider start with one facility and grow to nearly 700 beds with a 99% run-rate for the entire year so far? How do they plan to grow to 40 facilities within the next year and a half? The answer is Matt Boyle, CEO of Landmark Recovery. Matt and his team have created a model by thinking completely outside the existing playbook of addiction treatment. In fact, they saw what others had been doing in the field and made a conscious decision to do away with most of what they saw. Matt was incredibly gracious to share his strategies and many actionable tips on what scalable, long-term growth that works looks like.

Should you buy or lease? What's the advantage of hiring an attorney, vs an architect for zoning, vs a broker? Did you know you can get free rent or money for renovations built into lease agreements and renewals? This episode with Colin Carr, CEO of CARR Healthcare Realty, has many practical tips for sourcing locations as you start or expand your program.

Alumni programming is critical to patient success post-treatment as well as the financial stability of the program. Michael Maassel built Harmony Foundation's alumni program from scratch to the point where Harmony sees 40 or more admissions a month come through alumni referral. She has created an extremely engaged alumni community that benefits from a wide array of in-person and digital services. Join us on this episode to learn how she did it and how your program can do the same.

PR is often delegated to the marketing team or not done at all at many behavioral health organizations. Ted Bender, CEO of BeWell Network, sees it differently. Across roles and organizations, he has consistently become a go-to source for local media outlets, becoming the face of the company in the community. Now, he is even hosting his own national videocast on YouTube with some famous individuals. What's his process for gaining media exposure and, as a CEO with countless demands on his time, how does he decide how much time to allocate as well as the return on that investment. Join us for this excellent discussion as we answer those questions on this episode of the Recovery Executive Podcast.

Success in business is often about making big bets with limited data. However, consistency in execution and leading indicators can often fill in some of those data gaps over time. This approach to business growth and success works particularly well for marketing. Jason Perillo, CMO of High Watch Recovery, discusses some of the massive bets they've made recently and how they measure success and ROI over the long-term.

What are the forces that drive valuation? How does an owner know what a reasonable sale price is and how does a buyer calculate how much they should pay? This is not a simple calculation. It depends on many factors both internal and external to the business. Dexter Braff, President of the Braff Group, walks us through his 15+ years of experience doing M&A in the field of behavioral health. Some of the terminology we use in this one can be a bit difficult to differentiate, and can be used differently by different people, so a couple of definitions: Price - the final amount paid for the asset, which could be very different from the asset's intrinsic value. Speculation: The concept of paying a price above intrinsic value because the buyer believes they can sell it for an even higher price in the near future due to current market dynamics rather than underlying business fundamentals. Valuation (Intrinsic Value): The amount that the asset is worth based on business fundamentals, not including any frothiness in the market that may be over or undervaluing assets in a particular class or vertical.

There are multiple sources of capital to fuel growth for providers or to simply de-risk portions of the business. A sale-leaseback is one such vehicle that operates as an alternative to traditional bank debt or private equity. Patrick Haynes, Managing Principal at Wellness Realty, walks us through the pros and cons of the various types of financing and how they can work to provide much-needed capital or accelerate expansion for behavioral health providers.

Business development is a revolving door at many providers and remains one of the greatest areas of opportunity across behavioral health. How does one recruit, retain, and effectively train reps to bring out the best in them? I speak with Jordan Young of Jordan Young and Associates in this episode to learn just that.

Digital therapeutics are a new form of treatment where a doctor or other health professional prescribes digital content. Just like any other medication, the patient needs a written prescription. Pear Therapeutics has several FDA-approved digital therapies on the market already, including for addiction treatment. They provide low-cost and surprisingly efficacious care. Dr. Yuri Maricich, Chief Medical Officer for Pear, fills us in on this innovative form of treatment, how it fits into current continuums of care, and the results they've seen to date.

Rural areas hard hit by addiction are, unfortunately, often the least likely places in which to find treatment services, especially ones that accept Medicaid. The challenges to creating such programs are many. Nikki King, Manager of Behavioral and Addiction Services for Margaret Mary, overcame these challenges. In this episode, she shares with us her innovative approaches to stakeholder collaboration and program funding.

Removing barriers to treatment and improving patient outcomes are two of the core elements of any treatment program's mission. In this episode, I speak with Steve Randazzo, CEO of Aware Recovery. Aware is an innovative, home-based addiction treatment program that works with patients for up to a year providing extended care from a team of professionals. We discuss the logistics, outcomes, and payer relationships that have evolved over time as Steve and his team continue to grow Aware, now expanded into 9 states.

60% increases in patient responsibility collections? Patients sending thank you notes after paying their bills? Reduction in AMAs? Creating payment plans based on risk stratification data according to patient background? If you thought collecting deductibles and co-insurance would somehow have negative repercussions on your program, then you need to listen to this episode, where I speak with Chris Wolfington of FinPay on strategies to do all of the above.

Looking at 4 key quadrants that are the life's blood of any behavioral health system or treatment program, we explore the do's and don'ts of successful turnarounds around growth strategy. Gary Larcenaire of Project Ity has decades of experience doing both, so I'm excited to share his expertise on this episode.

After 40 years in the addiction treatment space, Doug Tieman is passing the torch as he retires. The industry has changed a lot in 40 years. Doug gives us insight into how Caron has changed and adapted in the field as well as how the field as a whole has changed, including how it will need to continue to change to meet the needs of tomorrow's patients. I thank Doug for his service and commitment to the recovery space. It was a pleasure getting his insights in this interview.

Improving clinical outcomes is dependent on feedback-informed care models. There is tremendous opportunity in the treatment space to track, analyze, and improve based on data. In this episode, I speak with Jared Dempsey, Chief Scientist at Trac9, where they have collected data on over 200,000 patients and already identified key data points that help their clients improve outcomes. I found this discussion incredibly valuable and know you will too.

How do you take a large problem, like an intake process that takes too long, and reduce time from call to admission by 80% or more in 3 months? Now how do you create a system that facilitates that kind of improvement across every department every month? That's what Sam Klinger, Director of Continuous Improvement for Rogers Behavioral Health, walks us through in this episode. As you can guess, your head may spin at the complexity of what a rapid improvement process entails, but, by the end of the interview, we'll have it broken down for you in a way that makes it understandable and actionable.

Navigating addiction treatment for patients can be very complicated. There are PCPs, therapists, court systems, and pharmacies to manage, just to name a few. Patient Care Coordinators can help patients through the complex array of paperwork and tracking during a time when they need to be focused on recovery. Kat Lehnert-Scott of Ashley Addiction Treatment walks us through the role and benefits to patients.

What do you do when people need their pain medication, especially for chronic pain patients? How do you manage both the addiction and the physical health needs? This is an extremely important question more programs should be asking. Ashley Addiction Treatment has created a special Pain Recovery Program. Jessica Vickers joins me on this episode to walk us through that program and how it helps individuals in this particular situation.

There has been growing focus on how outcomes tracking can support both improved patient care as well as improved relationships with the payers. Tom Britton, CEO of Gateway Foundation, has spent a lot of time an energy building outcomes tracking into their programming. In this episode, we hear how he did it and what results they've gotten.

Every leader has had to manage through crisis at some point or another and, with covid, everyone has a fairly recent experience. Kathleen Murphy, SVP at Farnum Center, had to manage through multiple crises during covid. The decision-making process, data needed, and sheer speed of events make crisis management far different from the normal day-to-day. In this episode, with covid as a background, we look at lessons learned from leading through any crisis and what it tells us about being prepared, how to operate in the crisis, and what takeaways exist after.

Addiction Campuses has an entirely new leadership team post acquisition and they're completely transforming the company around value and quality. Matt Morgan, the new CEO, is leading that charge, and someone I am personally a big fan of. Coming with extensive experience growing and scaling large healthcare companies, he brings us fantastic insights into how he's applying that expertise at Addiction Campuses.

Healthcare laws are complex to say the least. Regular attorneys just don't know enough, which is why I'm having Harry Nelson, Managing Partner of Nelson-Hardiman on this episode. We look at the current legal landscape for addiction treatment, how it's changed, and what are some of the pitfalls like free housing, travel arrangements, and marketing.

Ever had to turnaround an organization that was bleeding money and make it profitable? It's not easy. Manny Nsien, COO of Shadow Mountain Recovery, walks us through his experience doing exactly that. Then he talks further with me about what it takes to succeed in today's treatment landscape. I personally consider Manny to be one of the best COO's in the business, so get ready for some great insights.

Billing and Revenue Cycle Management is far more than submitting a claim followed by checking to see how much was collected. There are numerous steps in the process and not having them operationalized is a quick way to start losing serious revenue. Ben Dittman, CEO of Avea Solutions, walks us through the systems and processes providers need to know.

How do you get industry leading performance out of your business development team? The answer, not surprisingly, is different than what most providers focus on with their business development and community outreach teams. In this episode, I speak with Amy Kelley, VP of Business Development for Promises Behavioral Health, We go through the tactics, strategies, and philosophy that has enabled her to build one of the highest performing teams right now as the company rebuilds after the old Elements bankruptcy. It's a tightly focused conversation packed with value. Enjoy.

Families really want to help their loved one, but often feel at a loss. In some instances, they even feel actively discouraged from supporting their loved one for fear of being labeled an enabler or co-dependent. In this episode, I speak with Carrie Wilkens, founder of The Center for Motivation and Change, where we explore a heavily evidence-based, but little used strategy, called CRAFT (Community Reinforcement and Family Training).