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Medicaid Who’s Who Interview: Joseph Howard

Joseph Howard is the Chief Operating Officer at ARC Healthcare

Check out his LinkedIn profile HERE.

Which segment of the industry are you currently involved?

I am currently involved in healthcare consulting with a focus on providing results-driven and solution-focused services and software recommendations to clients.  We provide clients turnkey results that are meaningful, measurable and maintainable in contributing to overall quality and affordable care. Our goal is to ensure that clients are receiving the best value and up to date changes and innovations in the industry.  We support our clients by providing solutions in the following areas: 

i. Provider Network Development and Contracting Services to build a network(s) of qualified providers to address the needs of members and providers. 

ii.Offer Outsourced Call Center Support by managing the large volume of calls from both providers and members to help them navigate new requirements, provide education and direction to properly access care. 

iii.Use software solutions to create workflow efficiency, provide CRM support and manage provider network adequacy and streamline roster validation.  

How many years have you been in the Medicaid industry?

I have been in the Medicaid industry for over twenty-five years. 

What is your focus/passion? (Industry related or not)

My focus and passion, in general, is service, personally, as well as professionally, to serve those who are underserved, the least, the last, the left out. I have a strong desire to serve and offer those who are subjected to healthcare disparities, not necessarily due to something of their own doing, but based on their plight in life, an opportunity to receive healthcare on par with those who can afford it. My focus is on serving them because I firmly believe that the best way to be a good leader is to serve. 

What is the top item on your “bucket list?”

I have never really had a bucket list until my mother passed in October. There were two places that she wanted to go that she had never been and I tried to take her there, but she got to the point where she was mobile enough to go to those places. Rhode Island is one of them, and the other is the Holy Land. I want to do that because they meant so much to her and because of that they also mean a significant amount to me. 

What do you enjoy doing most with your personal time?

I enjoy spending time with family. I get a lot of strength and energy from family, whether we are sitting in a room, just laughing and joking, watching a movie, or just talking about how our day went. Family means a significant amount to me and I am just very thankful for them and for every moment that we have together. 

Who is your favorite historical figure and why?

In the grand scheme of things, it is Jesus because of what he stood for. He was divine, but he was human, and he showed us how to live out humanity while relying on divinity to lead the way. 

What is your favorite junk food?

My favorite junk food is plain potato chips. It can be Lay’s or it can be the ones with the ridges. I can never stop at one.  

Of what accomplishment are you most proud?

The accomplishment I am most proud of is becoming the fulfillment of my mothers’ dreams. What I mean by that is, in the era that she grew up in, during the height of civil rights, and not having much opportunity for educational advancement, she always stressed the importance of completing high school and getting a college education, even though at the time she did not have that herself, she later went on to  get  her college degree, but she pushed me to do that long before, and although as I was matriculating through school at all levels and I was learning things that she didn’t know, she still realized the importance of what it meant for my future and just becoming the fulfillment of that is my proudest accomplishment because it set the stage for many others to follow. 

For what one thing do you wish you could get a mulligan?

This is quite funny to me, but my high school senior portrait. I had a lot going on and so much was happening that I forgot and it was at the end of  band practice one evening that somebody brought it to my attention that it was the last day for senior portraits. There was no other time for me to take a senior portrait. I had just come out of the hot sun after 2 hours of practice and was not picture ready, but if I didn’t get the portrait at that time, I wouldn’t be in the year-book. It wasn’t the best portrait, so if I could do that over again, it would put a smile on my face. 

What are the top 1-3 issues that you think will be important in Medicaid during the next 6 months?

The number one issue is being able to properly and effectively respond to what the new healthcare normal will look like post the COVID19 pandemic.  It is important that we plan now for what’s to come otherwise, we will scramble to adequately provide and meet healthcare needs. 

Number two is focusing on the quality of healthcare. It has become apparent through the effects of COVID19 that there are significant gaps in the quality and  service of healthcare.   

Number three is the focus on our preventive healthcare efforts, because when we focus on preventive measures, we can avoid things like the full onslaught of COVID19. While we may not avoid it happening, we can avoid the number of lives it reaches because by taking a preventive posture now.  This is a testament to the Benjamin Franklin adage, “An ounce of prevention is worth a pound of cure.”  Although he was addressing fire safety, the sentiments rang true for healthcare and many other life experiences. We can get messaging out sooner. We can raise the awareness of it. Tens of thousands of people had been affected and quite possibly died before we became serious about the messaging. 

Know someone in the space who’s doing great work and is an all around interesting person?

Send a note to clay@mostlymedicaid.com to nominate them for the next round of Medicaid Industry Who’s Who Interviews.

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Medicaid Who’s Who Interview: Amy Riegel

Amy Riegel is the Director of Housing at CareSource

Check out her LinkedIn profile HERE.

Which segment of the industry are you currently involved?

I am approaching my 4 year anniversary with CareSource, a non-profit Managed Care Organization that covers nearly 2 million members that live in Ohio, Indiana, Georgia, West Virginia, and Kentucky. Since the beginning, I have been a part of the Life Services team, which is focused on the integration of the social determinants of health into all lines of our business.

How many years have you been in the Medicaid industry?

CareSource is my first role within the Medicaid industry. Prior to CareSource I had worked in multiple roles that helped improve communities for individuals living in poverty. My work included education, strategies to end homelessness, and revitalizing communities after the housing crisis. When CareSource started Life Services they took the bold approach to hire experts from outside of the Medicaid industry – I am very thankful for that innovative vision. I jumped into my new career and have been learning something new every day. After four years I can now speak “fluently” housing and healthcare.  

What is your focus/passion? (Industry related or not)

Personally and professionally my passion is for building communities through the lens of where we live. At work, I have the opportunity to create strategies to increase the availability and affordability of housing for our members. I love every aspect of this work, especially the fiscal and social policy related to affordable housing. Public housing benefits are incredibly different from health coverage – the contrast of the two create the perfect playground for my mind to work. Personally, my husband and I also rehab historic homes. Helping to bring new life to a beautiful old structure is immensely gratifying.

What is the top item on your “bucket list?”

Almost all of my “bucket list” items are focused on traveling. I love to explore new places near and far. In the United States, I am getting closer to reaching my goal of visiting all 50 states and every National Park. My favorite travel spots to date are watching the sun rise from Haleakala National Park in Maui and hiking Bryce Canyon National Park in Utah. On the top of the list for places that I want to visit is Denali National Park in Alaska. I also love to travel abroad, right now Italy is at the top of that list.

What do you enjoy doing most with your personal time?

Currently, my free time is consumed by my three young daughters. Our nights and weekends are filled with school and sporting events. I enjoy being involved in their activities either on the sidelines cheering, helping them master a new skill, or volunteering annually as the Girl Scout Cookie Mom. Our lives can be very hectic but it is amazing to see the world through their eyes.

Who is your favorite historical figure and why?

I was an Accounting major in college, until my first Political Science class when I learned about Archbishop Desmond Tutu and the South African Truth and Reconciliation process after the end of Apartheid. His work and steadfast belief is advocating for what is right, no matter the consequences, became a guiding light. He was a mediator, influencing others by helping them to find understanding, rather than trying to force his viewpoint. He helped people to find peace within the political system and within their hearts. I graduated with the degree in Political Science and embarked upon my career with the intention to help the world heal from the wrongs of the past and build just societies.

What is your favorite junk food?

Hands down – a brownie. I can skip most sweet temptations but I can’t say no to a brownie.

Of what accomplishment are you most proud?

Being a mom to my three daughters is truly my greatest accomplishment. I faced many challenges on the journey to becoming a mother, but the process made me stronger and more resilient.

For what one thing do you wish you could get a mulligan?

I believe that everything happens for a reason, and no matter the outcome, it is what you learn from the situation. I have not always made the best decisions and there are many things that did not turn out the way I wanted, but it is the success and the failure that has brought me to this point. For the important moments and decisions, there is nothing that I would do over.

What are the top 1-3 issues that you think will be important in Medicaid during the next 6 months?

Of course, the social determinants of health. I believe that we are starting to understand how to address social needs within the structures of MCOs or health providers. The healthcare system has an infrastructure that can help to facilitate the delivery of interventions and services. If we can build strong relationships with community based organizations we will have the ability to comprehensively address individual social needs. This work is essential, we must double down and take it to scale. However, the most important part is the next step – we must start to dismantle the systemic constructs that create the social need. We must get upstream. For an example – there are programs that serve homeless members and help them find housing. We have programs at CareSource, other MCOs and Hospital Systems across the nation are also creating programs. In the next 6 months we must start talking about why people are becoming homeless, how we prevent homelessness, and how do we screen for housing instability. The health and financial outcomes will come from curing the social issue, not treating it.

Know someone in the space who’s doing great work and is an all around interesting person?

Send a note to clay@mostlymedicaid.com to nominate them for the next round of Medicaid Industry Who’s Who Interviews.

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Medicaid Who’s Who Interview: Michelle Ann Passaretti

Michelle Ann Passaretti, MSN, BSN, RN, CCM is the Senior Director of Innovations for Geisinger’s Steele Institute of Health

Which segment of the industry are you currently involved?

I currently work in the Steele Institute of Innovations under the health pillar for Geisinger Health System. Geisinger is an integrated care delivery system in rural Pennsylvania serving over 3 million patients in 45 counties.

How many years have you been in the Medicaid industry?

I have been involved in the Medicaid industry all of my professional career, which has been 25 years now.

What is your focus/passion? (Industry related or not)

My biggest focus as well as passion as a nurse, is addressing population health needs. I am particularly interested in just how profoundly social determinants of health has on one’s chronic disease. Its enlightening to see health care taking an interest in this space.

What is the top item on your “bucket list?”

I don’t really have a bucket list. I try to live each day to the fullest and appreciate life events both big and small, good and bad. I feel incredibly blessed to be living this life however If I had to choose something that would be considered a bucket list item, I suppose I would say a big family vacation to somewhere like Ireland to better appreciate the beauty in our Irish heritage.

What do you enjoy doing most with your personal time?

Spending quality time with my family and friends. The older I get I realize just how important time is. It seems like only yesterday my children were babies however they are far from it. My son just turned 20 and my daughter is 18. Time certainly waits for no one. Outside of quality family time, I enjoy baking and crafting.

Who is your favorite historical figure and why?

I would have to say Florence Nightingale. As the founder of modern nursing, her accomplishments in providing quality care while reducing mortality rates forever changed the role nurses played in healthcare.

What is your favorite junk food?

Pizza…Breakfast, lunch, or dinner-anytime is a good time for pizza!

Of what accomplishment are you most proud?

Personally, I am incredibly proud of my children. They are humble, kind, bright, and passionate young adults with a ton of ambition.

Professionally I am proud of the innovative programs that Geisinger has developed over the years to better care for the patients entrusted to us. There is no greater gift than caring for patients and being able
to meet their needs.

For what one thing do you wish you could get a mulligan?

If ever given a second chance, I would ask to rewind the hands of time. There were so many “little” things taken for granted, so many missed opportunities to say thank-you for everything, to show appreciation for nothing, and to
acknowledge something.

What are the top 1-3 issues that you think will be important in Medicaid during the next 6 months?

Use of artificial intelligence

Expanded focus on SDOH

Greater emphasis on wellness and prevention

Know someone in the space who’s doing great work and is an all around interesting person?

Send a note to clay@mostlymedicaid.com to nominate them for the next round of Medicaid Industry Who’s Who Interviews

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Medicaid Who’s Who Interview: René González

René González, MBA, Ph.D.

Affiliate Faculty at University of Colorado Boulder

Community & External Relations Strategy at Colorado Access

Check out his LinkedIn profile HERE.

Which segment of the industry are you currently involved?

Healthcare, Medicaid Industry.

How many years have you been in the Medicaid industry?

7 years.

What is your focus/passion? (Industry related or not)

Social determinants of health, K-12, and higher education equity.

What is the top item on your “bucket list?”

After traveling to 6 of the 7 continents, my top bucket item is to visit Antarctica.  

What do you enjoy doing most with your personal time?

Traveling, exercising, and Fútbol (Soccer).

Who is your favorite historical figure and why?

Cesar Chavez, advocate for farm workers. My family also worked the fields in rural Colorado.

What is your favorite junk food?

Any and all desserts.  

Of what accomplishment are you most proud?

Completing my Ph.D.

For what one thing do you wish you could get a mulligan?

Spending more time with my grandparents in Mexico.

What are the top 1-3 issues that you think will be important in Medicaid during the next 6 months?

a.     Behavioral Health Integration

b.     Social Determinants of Health

c.     Medicare for all  


René is also speaking at Insight Exchange Network’s 2nd annual Social Determinants of Health Action Forum in Miami, FL November 14-15, 2019.

For more information about the conference, click HERE.

Know someone in the space who’s doing great work and is an all around interesting person?

Send a note to clay@mostlymedicaid.com to nominate them for the next round of Medicaid Industry Who’s Who Interviews

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Medicaid Who’s Who Interview: Pamela Mokler

Pamela Mokler, MSG is Post-Acute, LTSS & SDOH Innovation Consultant at Pamela Mokler & Associates, Inc.

Check out her LinkedIn profile HERE.

Which segment of the industry are you currently involved?

I am currently working in the “medical and social integration” space as a consultant to build bridges and integrate our silos. My focus is connecting health plans, health systems and providers (medical, LTSS and SDOH, as well as affordable housing), to create person-centered care that focuses on the holistic needs of Medicare and Medicaid beneficiaries. This involves the creation of innovative and common-sense solutions and interventions that improve the quality of care and lives of older adults, people with disabilities, the institutionalized and people experiencing homelessness.  This sometimes also involves writing funding proposals to launch innovative models and expand Medicaid and existing programs into new markets.

How many years have you been in the Medicaid industry?

My focus has been on Medicaid-eligible individuals for over 20 years, although I began working with older adults as a nurse aide at the age of 14 at a Medicaid-financed nursing/rest home in upstate New York. I segued into law and became a paralegal for several years, which gave me a strong foundation for creating partnerships. After a 97-year old extended family member, who I was caring for in my home, passed away, I was drawn back into working with older adults, and volunteered as an LTC Ombudsman while I was getting my Master of Science degree in Gerontology.

SCAN Health Plan engaged me immediately after graduation, and I realized that I could impact older adults and people with disabilities in a greater way by helping develop Medicare Special Needs Plans (SNPs) and building community outreach teams to enroll economically disadvantaged beneficiaries.  I ended up founding a senior housing company in the late 1990s to provide contract service coordination so low-income affordable housing residents could receive services and continue to age-in-place (primarily Medicaid and duals). After serving as Executive Director of an Area Agency on Aging (which are federally mandated to assist older adults with the greatest needs, with an emphasis on low-income ethnic minorities), I realized how fragmented and duplicative our systems are and began focusing on integration.

For the past 16 years, I have served as an Executive Advisor, Vice President of LTSS and Consultant, to health plans and other providers, focusing on integrating Medicare Advantage, SNPs and Managed Medicaid plans with social services providers by building networks, negotiating contracts and launching innovative pilots and community partnerships.

What is your focus/passion? (Industry related or not)

I was fortunate to discover my passion for older adults as a teenager, and to spend most of my life working to improve their quality of care and lives. Helping organizations serving people experiencing homelessness is a more recent passion, especially since the number of older adults experiencing homelessness is continuing to rise at an alarming rate. I miss working with older adults directly; however, I am grateful that I can impact their lives by focusing on improving access to care and much needed social supports.

What is the top item on your “bucket list?”

Continuing to travel to countries not only to see tourist sites, but to also learn how they are caring for their most vulnerable populations. We can learn a lot from what others are doing in the space.

What do you enjoy doing most with your personal time?

I love to travel, and it’s a special treat when I can combine travel and my passion for older adults and see how they are living and being cared for in other countries. Some of my favorite places have been Peru, Thailand, Argentina, and Italy. I also enjoy spending time outdoors with my partner, family and/or friends – hiking – especially in Sedona, the Eastern Sierras and Utah Parks, walking on the beach or in the woods, biking, kayaking, skiing and dancing. I went sky diving once and would love to do so again. I also enjoy quiet evenings, going out to dinner and to concerts, and reading historical novels and autobiographies.

Who is your favorite historical figure and why?

There are so many famous and not-so-famous historical figures that I admire, especially those who took great risks to improve the lives of those less fortunate than themselves. A current individual whom I greatly admire is Supreme Court Justice Ruth Bader Ginsberg. I have a tremendous amount of respect for those who speak on behalf of and do for those who cannot do for themselves.

What is your favorite junk food?

Chocolate!

Of what accomplishment are you most proud?

On a personal level, I am most proud of my two daughters, who have evolved into amazingly strong and talented young women. Professionally, I am proud and grateful to be able to work with leaders running health plans and systems, social services organizations and affordable housing companies who have and continue to give me opportunities to serve our vulnerable populations. I view our siloed systems from 30,000 feet, and see people, companies, and programs that could and should be connected. Some of those projects include integrating a health plan with an Area Agency on Aging (AAA), an Independent Living Center (ILC), a Long-Term Care Ombudsman program (LTCOP) and a Recuperative Care facility for people experiencing homelessness who need a place to heal following hospitalizations.

For what one thing do you wish you could get a mulligan?

If I was given the opportunity to run another government agency, I would take a more measured and incremental approach to changing systems. I would spend more time listening to the individuals who have worked in that space for many years and ensure key stakeholders are on board with the changes before agreeing to such a large restructuring. Too many strategic plans and innovative programs are created that are not sustainable because of politics and resistance to change.

What are the top 1-3 issues that you think will be important in Medicaid during the next 6 months?

We are living in exciting times – the health care industry has awoken to the fact that continuing to spend money on medical care without looking at patients’ social determinants needs is like throwing money into a black hole. If we’re going to bend the cost curve on health care, we need to:

Get physicians and the entire medical community on board with looking at the whole person, and to play a key role in ensuring patients have access to critically needed social services and support that positively impact their health.

Continue to innovate to address Social Determinants of Health needs

Develop technology platforms that are interoperable and allow beneficiaries, their caregivers, and all their providers, whether medical, behavioral/mental health, social community-based services, long term care, etc., to view and share data to ensure people are getting the right care, at the right time, in the right place.


Pam is also speaking at Insight Exchange Network’s 2nd annual Social Determinants of Health Action Forum in Miami, FL November 14-15, 2019.

For more information about the conference, or how to sign up, click HERE.

Know someone in the space who’s doing great work and is an all around interesting person?

Send a note to clay@mostlymedicaid.com to nominate them for the next round of Medicaid Industry Who’s Who Interviews

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Medicaid Who’s Who Interview: Brian Castrucci

Brian Castrucci, DrPH, MA is President and Chief Executive Officer at de Beaumont Foundation.

Check out his LinkedIn profile HERE.

Which segment of the industry are you currently involved?

I currently work in health philanthropy. As President and CEO of the de Beaumont Foundation, I am fortunate to touch many different areas, including the government public health workforce, partnership development with multisector collaboratives, and policy work. Previously, I spent a decade working in state and local health departments. 

How many years have you been in the Medicaid industry?

I actually have never been in Medicaid, but public health and Medicaid are intimately related. In my past roles as a public health leader, several programs that I oversaw had direct links to Medicaid.

What is your focus/passion? (Industry related or not)

Besides my family, Patriots football, and NC State Wolfpack football, I am super passionate about changing communities so that everyone has their best chance at achieving their optimal health. When we say that your zip code has more impact on your health than your genetic code, we are essentially pointing out that we are playing a rigged game – a game that benefits those with and in power at the expense of the poor and vulnerable. That’s not the world I want to leave to my kids. 

What is the top item on your “bucket list?”

Personally, I would like to spend some time whale watching in the waters off Seattle. Professionally, the top item is helping transition our national conversation from a focus on healthcare and insurance to one that considers health more holistically. 

What do you enjoy doing most with your personal time?

Of course, spending time with my kids (Evan, 10, and Chloe, 8). As nerdy as this may sound, I also love to write – blogs, books, journal articles, tweets. Sharing ideas is so important, and the Internet and social media have made sharing our ideas so much more egalitarian. Using these tactics effectively is especially important in public health settings: social media gives our field the chance to counter misinformation, engage people and communities directly, and share new findings.

Who is your favorite historical figure and why?

Jimmy Valvano, head basketball coach at NC State from 1980 to 1990. Jimmy V was the consummate underdog – winning the 1983 NCAA basketball championship against all odds. His subsequent battle with cancer led to the creation of the V Foundation. At his last public appearance before his death at the 1993 ESPY Awards, he said something that I have thought about almost every day since: “If you laugh, you think, and you cry [every day], that’s a full day.   That’s a heck of a day. You do that seven days a week, you’re going to have something special.” 

What is your favorite junk food?

Pepperidge Farm coconut cake. My wife hates it, but it was something special that I would get at my maternal grandmother’s house when I would visit as a child. So, it may be the memories that are satisfying more so than the cake. But if the Pepperidge Farm people read this and want to send one over, I wouldn’t object. 

Of what accomplishment are you most proud?

I am most proud of the opportunity I was given to lead the de Beaumont Foundation. Our founding CEO (retired) and Board Chair, James Sprague, was personally entrusted with Pete de Beaumont’s estate upon his passing. Jim has had a role with the Foundation since before it even began, more than 25 years. It was truly an honor to assume the role of President and CEO of de Beaumont and have a role in this amazing Foundation.

For what one thing do you wish you could get a mulligan?

Nothing. Always hit the ball where it lies. You never know what will happen next. I’ve had success. I’ve had failures. I’ve made good decisions and bad. Each and every one got me to where I am now, and I wouldn’t trade that for anything. 

What are the top 1-3 issues that you think will be important in Medicaid during the next 6 months?

Medicaid will need to expand its allowable costs and broaden its investments. Bugs and bacteria aren’t driving costs anymore. Today, the major contributor of ill health is the lack of strong foundations for community health – housing, food, income equality, education access. Medicaid will need to consider how to address patients’ social needs as part of restoring their health. Related, Medicaid continues to be the largest single line item in most state budgets. Legislators who are concerned about the growing cost burden of Medicaid need to focus on policies that create the environment where everyone can be healthy. Focusing simply on why Medicaid recipients are unhealthy and paying for their healthcare is like feeding the fish but not cleaning the tank. Cost-effective programs that set people up for a lifetime of health, like high-quality, affordable early childhood education, are a key part of this. 


Brian is also speaking at Insight Exchange Network’s 2nd annual Social Determinants of Health Action Forum in Miami, FL November 14-15, 2019.

For more information about the conference, or how to sign up, click HERE.

Know someone in the space who’s doing great work and is an all around interesting person?

Send a note to clay@mostlymedicaid.com to nominate them for the next round of Medicaid Industry Who’s Who Interviews

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Medicaid Who’s Who Interview: Walter Rosenberg

Walter Rosenberg, MSW, MS-HSM, LCSW is Director of Social Work and Community Health at Rush University Medical Center

Check out his LinkedIn profile HERE.

Which segment of the industry are you currently involved?

For about the last 11 years, I’ve been with Rush University Medical Center – a large, urban, academic medical center in Chicago.  Within Rush, my main focus is on care coordination, care transitions,
and the population health world, focusing on providing critical non-medical support to our patients in order to improve their health outcomes. 

How many years have you been in the Medicaid industry?

I have been involved with Medicaid for the full 15 or so years of my career, since every job I have ever held relied fully or partially on Medicaid funding.  At Rush, the large Illinois move to managed
care some years back, has made Medicaid a focus of much attention.  In fact, Rush runs a Medicaid ACO for one of the state payers, which has been a source of much learning.  In an era when value based contracts live in an uncomfortable alliance with a slowly
fading fee-for-service funding stream, understanding the impact Medicaid has on our payer mix and developing strategies to improve post-acute outcomes is a top priority. 

What is your focus/passion? (Industry related or not)

Within the industry, my passion hovers around that tricky medical and non-medical interface, where the everyday, non-medical lives of our patients meet their acute or chronic medical needs.  Clearly,
the vast, vast majority of us live in the non-medical world.  Our lives there dictate the way we recover from illness or manage ongoing conditions.  Helping the healthcare system effectively bridge the gap between the two is a very tough puzzle.  This is where my passion lies, particularly as it relates to the models of care (Bridge and AIMS) we disseminate across the country via our Center for Health and Social Service Integration (CHaSCI), where I serve as co-director. 

What is the top item on your “bucket list?”

I don’t have a bucket list.  I understand how this can create a goal-driven approach to life for many folks and I celebrate that approach when I encounter it.  However, I’m just happy when I occasionally
get to do the things I already love to do. 

What do you enjoy doing most with your personal time?

Personally, top priority is always family.  My incredible, strong, and smart wife, Sonya, and my two children – Vera (9) and Danny (5) – who fill my heart with love and gratitude every day.  Outside
of family, I like to get my hands dirty.  Gardening, cooking, cleaning, knitting, the occasional DIY project – that sort of thing.  At the end of day, though, I am most nourished by reading.  I’ll trade an evening with a book and a cold beer in my backyard for just about anything.  So I suppose you can make that the one recurring item on my bucket list!

Who is your favorite historical figure and why?

I’m afraid I don’t have a personal favorite historical figure.  You know how they say, “Never meet your heroes?”  I think it’s because if you zoom in close enough, you’ll see major flaws in so many of our historic and contemporary heroes, as well as the hand of those that got to write history or make the news.  I believe we will never hear about the truly best people out there.  They probably have pretty crappy PR departments!  Instead, I like to learn what I can from historical lore, and from the inspiring people I meet every day, who will never make it into a history book.

What is your favorite junk food?

Wendy’s, hands down.  I used to work there in high school and believe it or not, it only made me love it more.  Especially their spicy chicken sandwich and chili.  I do not get any marketing dollars from them.  Yet (are you listening Wendy’s??). 

Of what accomplishment are you most proud?

No matter where I look in my nearly 40 years, all I see is an army of people who I had the privilege of benefiting from.  I can’t really point to anything that’s my own, I’ve always either had incredible
helpers or motivators.  Though not at all a singular accomplishment of mine – that honor most easily rests with my boss and mentor, Robyn Golden – I’m proud of CHaSCI (the center mentioned earlier).  Social work is a discipline that is grossly underappreciated
in health care.  CHaSCI has been a great vehicle for spreading the good word about the meaningful impact social work can bring to patients.

For what one thing do you wish you could get a mulligan?

Another non-answer for me, I’m afraid.  People say hindsight is 20/20, but I never believed that.  No decision is a singular split between option A and option B.  Any fork in the road always leads down
a myriad of other experiences that build on each other and yield something special.  So we may
think a certain choice would have been better, but in 99.9% of the cases, we have no way of truly knowing how life would have unfolded.  From that perspective, though there many “mistakes” I’ve made in my life, I can’t imagine ever changing anything, because my life would be completely different, and I like mine as is, warts and all, as they say. 

What are the top 1-3 issues that you think will be important in Medicaid during the next 6 months?

Three related priorities come to mind:  1) We have to understand how merge the community and health care funding streams.  Community Based Organizations (CBOs) significantly impact health outcomes and are part of the larger patient continuum.  Separating funding streams makes it much harder to align processes and priorities.  There is a great deal of opportunity to address this, particularly on the managed care side, with some early efforts already underway. Medicaid can be a leader in disseminating the impact.  2) I very much hope that technology – medical records, in particular – can help CBOs and health care organizations work on the same longitudinal patient goals, rather than the episodic approach that is currently the norm.   3) We need to get better at providing role clarity for the allied health professionals.  Social workers, navigators, community health workers, medical assistants, nurses, etc. all have critical roles to play in the care of our patients. 
Unfortunately, since there are some tasks that all of these disciplines are able to provide, it has been very challenging to create a well-defined, comprehensive health care team.  I’m hoping that some of our CHaSCI work, as well as the work of many like-minded organizations across the country can help us to meet that goal. 

Know someone in the space who’s doing great work and is an all around interesting person?

Send a note to clay@mostlymedicaid.com to nominate them for the next round of Medicaid Industry Who’s Who Interviews

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Medicaid Who’s Who Interview: Sharon Raggio

Sharon Raggio, LMFT, LPC, MBA  is President and CEO Mind Springs Health

Check out her LinkedIn profile HERE.

Which segment of the industry are you currently involved?

Mind Springs Health is the leading provider of mental health and addiction treatment on the western slope of Colorado and lives out its mission of providing recovery and resiliency to people, families, and communities through its excellent continuum of behavioral health care services – from mobile crisis response to 12 outpatient offices to West Springs Hospital, the only psychiatric hospital between Denver and Salt Lake City.  We are pleased to be in over 100 schools as well as in locations with over 100 different partners.  We believe it is critical to our mission that we offer our services where people are, as that is a secret sauce ingredient to engagement and change. 

How many years have you been in the Medicaid industry?

We have been in the Medicaid business since our inception in 1972!  Personally I have worked in Community Mental Health for over 40 years….yes…. I started when I was 12! 

What is your focus/passion? (Industry related or not)

I personally love what Community Mental Health offers!  It is a sacred honor to be a partner in creating change in an individual, family, or community.  There is nothing that fills my heart like Community Mental Health!  The best news is that people can and do recover!  I am very pleased that we are starting to recognize the co-morbidity between physical & mental health and excited to be at whole-person planning tables. 

What is the top item on your “bucket list?”

Absolutely going to Italy!  I had the good fortune of living in Europe for many years as a young adult and now I’d love to go back with my family.  The Italian culture is unique! 

What do you enjoy doing most with your personal time?

Beside travel, which expands me as a person, I love to walk with our two standard poodles, Timbuktu and Corrina.  We live in western CO and have rich outdoor beauty to explore.  I also love to read good mystery books. 

Who is your favorite historical figure and why?

Marie Curie, a Polish and naturalized-French physicist and chemist who conducted pioneering research on radioactivity. She was the first woman to win a Nobel Prize, the first person and only woman to win it twice, and the only person to win it in two different scientific fields. She was also the first woman professor at the University of Paris.  Some of her more famous quotes include “Nothing in life is to be feared. It is only to be understood.” And when questioned about being a woman with a family & working   in science she replied “Well, it has not been easy”.  

What is your favorite junk food?

It has to be vanilla ice cream with chocolate syrup on a very hot day!  Nothing quite like that sensation of cold ice cream, hot chocolate souse, and a hot day!  YUM! 

Of what accomplishment are you most proud?

We recently were honored to receive the IHI Sherman Award for Patient Engagement.  Our amazing staff developed “Rapid Recovery Clinics” for people with depression and the model allows patients to choose when they want to be seen, how often, and who they want to see of their treatment team.  The results are amazing, with 68% of people moving into a recovery phase from depression in only 6 weeks!  That means people are doing well, our clinical staff know they made a difference, and our offices can serve more people in need!  A triple win! 

For what one thing do you wish you could get a mulligan?

I have come to understand that relationships are what are important in life.  My do-over would involve absolutely involve healing a relationship.  It is important to be quick to recognize when I make a mistake or push too hard on a relationship.  Forgiveness goes along with this concept. 

What are the top 1-3 issues that you think will be important in Medicaid during the next 6 months?

I think state governments struggle with how to fund and pay providers for Medicaid.  While there are many ideas about value-based payments, there is a grand experiment occurring with how to make that actionable and what the valued outcomes should be.  Additionally, specific to the world of behavioral health, we have a crisis-level shortage of providers.  Funding prevention and resiliency-building programs is a policy I hope States will shift towards in the near future. 

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Medicaid Who’s Who Interview: Robert Garnett

Robert Garnett, MBA, CHIE, is President, Amerigroup Tennessee at Anthem, Inc

Check out his LinkedIn profile HERE.

Which segment of the industry are you currently involved?

Amerigroup Tennessee is a Medicaid Managed Care Health Plan and is part of the Medicaid Central Region and Government Business Division at Anthem, Inc. We are privileged to serve approximately 400,000 Tennesseans in the TennCare program across TANF, SSI, LTSS, and IDD (ECF) products. TennCare is regarded by most as one of the most advanced and innovative Medicaid programs in the country, so it is both exciting and daunting to be on the forefront of the industry. We have a terrific team of experienced and passionate leaders at Amerigroup Tennessee and it is my absolute honor to lead them and deliver on our promise to not only meet the needs of our members, our providers, and the State of Tennessee, but do so with a keen eye towards the future.

How many years have you been in the Medicaid industry?

I’ll be honest and admit that I didn’t know the difference between Medicaid and Medicare when I first joined Amerigroup in 2007. I have been privileged to stay involved in Medicaid ever since, serving in a variety of Corporate and health plan roles over 12 years. I was selected into Amerigroup’s Leadership Development Program (LDP) early on in my career and it was nothing short of a life changing experience to get exposure to our Executive Leadership Team and spend time in Business Development, Government Relations, Product Development, and Quality during a time of so much growth and industry maturation. Since 2011, I have spent the majority of my time in the Southeast serving on the health plan Operations side and in leadership roles in Georgia, Kentucky, Louisiana, and now in Tennessee since 2014.

What is your focus/passion? (Industry related or not)

I am passionate about collaborating and engaging with our providers, community-based organizations, and the State of Tennessee to achieve excellence in providing care and solutions to the Medicaid population through innovative, engagement-focused approaches. Amerigroup’s focus on addressing our members’ barriers to health has potential to revolutionize how we think about our healthcare system. It’s exciting to be in a role and at a company with the ability to impact these social determinants of health. Leveraging technology and engaging our members where they are presents significant opportunity to identify and combat some of the large social barriers to care that are at the heart of the challenge we face every day as a Medicaid Managed Care organization in improving the health of our members.  

What is the top item on your “bucket list?”

Professionally, I would love to be regarded as a leader in the movement to address social barriers to care when all is said and done. Improving the fundamental way care is delivered would be a monumental change in the health care system, but a change in my opinion with huge return for all. Personally, I would love to make it to Australia with my wife. We had the pleasure of going to New Zealand before we had our children and it was a truly fantastic part of the world unlike any other place I have ever been.

What do you enjoy doing most with your personal time?

Nothing helps get my energy level up and my day off to a great start than getting a workout in, particularly when the activity is out on the trails in the Tennessee woods near my house. I am someone that truly enjoys nature and the outdoors and whether it’s on a trail in Tennessee or climbing a mountain in Colorado, it’s always enjoyable and helps me put everything into perspective. It also happens to be where I do my best innovative thinking and problem solving.  

Who is your favorite historical figure and why?

Without George Washington’s leadership, many other great leaders in our country’s history- Abraham Lincoln, Martin Luther King, Jr, Franklin Roosevelt, etc. wouldn’t have had the opportunity to have had the impact they did if not for Washington’s tenacity, steadfastness, and his ability to make decisions during difficult times and as our country’s first President.  I’d particularly recommend “Washington,” by James Thomas Flexner, which provides a very interesting and different look into his life.

What is your favorite junk food?

My wife threw a candy themed party for my 30th birthday and so that pretty much speaks for itself. I am a huge movie buff and a trip to the theatre isn’t complete without a box of Junior Mints to enjoy.

Of what accomplishment are you most proud?

I was extremely fortunate to be the project leader for Amerigroup Georgia’s RFP submission for Foster Care when the population first moved into managed care and we were selected to be the first managed care organization to lead it. The process and solution development exemplified everything about teamwork and buckling down against tight timelines and a challenging environment that I enjoy most in this industry. The opportunity to create innovative solutions and best practices that improve the care for such a vulnerable population was extremely rewarding both professionally and personally.

For what one thing do you wish you could get a mulligan?

Missing my twins’ 2nd birthday for a business trip. It was an important lesson in proper work life balance. What that taught me is that more often than not, there is someone else that is more than ready to jump in and it affords them experience that they otherwise might not get and ensures you remain focused on the most important things in life. It also demonstrates and supports your leadership philosophy to live by the words you preach.

What are the top 1-3 issues that you think will be important in Medicaid during the next 6 months?

Health care reform, specifically work requirements, block grants, and other waiver requests clearly pose the greatest area of change, opportunity, and disruption in Medicaid Managed Care.

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Know someone in the space who’s doing great work and is an all around interesting person?

Send a note to clay@mostlymedicaid.com to nominate them for the next round of Medicaid Industry Who’s Who Interviews

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Medicaid Who’s Who Interview: Mark Shaffer

Mark Shaffer is Vice President of Medicaid Operations at BlueCross BlueShield of South Carolina

Check out his LinkedIn profile HERE.

Which segment of the industry are you currently involved?

I work in BCBSSC’s Celerian Group, where I am responsible for the Medicaid Operations Division. The Celerian Group is a collection of companies that primarily provide services to Government Programs. My team currently delivers Medicaid related services including Claims Processing, Provider Enrollment, Provider Call Center services, Eligibility application processing, and Third Party Liability functions.

How many years have you been in the Medicaid industry?

I started in Medicaid back in 1988, I like to think those of us with this length of service have a genetic predisposition rather than a defect, but only history will decide that. I have been fortunate to work in a wide variety of market segments over my career and the breadth of this experience has certainly kept things interesting over the years.

What is your focus/passion? (Industry related or not)

Meeting new people and helping them if I can. My father, a retired Marine, recently recounted that when I was in Kindergarten living in Korea when they met new people, they would say “oh, you are Mark’s parents”.  Growing up I lived in 11 houses before the age of 13 and my wife of 30 years and I have just completed our 11th move to our 6th State! No matter the different backgrounds and perspectives over the years it is amazing how much we are alike and share the same needs. By the way, everyone also thinks their traffic is terrible!

What is the top item on your “bucket list?”

My wife and I have discussed creating a behavioral health charity to help working families that are struggling with children with behavioral health needs. Unfortunately for working parents, the current system does not provide the support necessary to help children when needed.

What do you enjoy doing most with your personal time?

I love motorcycles and the camaraderie of riding with friends. It really doesn’t matter where we go it is about getting away from the day to day and enjoying the ride and the shared experience.

Who is your favorite historical figure and why?

If you asked which historic figure I would want to meet, it would be Jesus. Just too many answers that could be cleared up in a single meeting! But since that isn’t the question, my favorite other historic figure is Peter the Great. While he is known for conquering additional territory and expanding his empire he also lead a cultural renaissance to modernize his country based on his experiences with Western Europe leaving a lasting legacy on the world.

What is your favorite junk food?

Bacon. Although bacon should never be referred to as junk food.

Of what accomplishment are you most proud?

Helping to raise my three adult children and having them all out of my house!

For what one thing do you wish you could get a mulligan?

In the early 90’s when I was with Electronic Data Systems (EDS), we implemented the FLORIDA system (integrated eligibility). The system served Florida well for decades (all systems end up being legacy systems at some point), unfortunately EDS and the State ended up in a protracted legal dispute. The dispute negatively affected the company, reduced competition in the market, and disrupted service to the citizens. I think I would have made different recommendations to my leadership if we had a mulligan.

What are the top 1-3 issues that you think will be important in Medicaid during the next 6 months?

Expanded use of social determinants of health

Disruption from early adopters using AI and related technologies in the health insurance space

The impacts continuing industry consolidation

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Know someone in the space who’s doing great work and is an all around interesting person?

Send a note to clay@mostlymedicaid.com to nominate them for the next round of Medicaid Industry Who’s Who Interviews