The Recovery Executive Podcast

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 are 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 Jaime 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.