Medicaid Who’s Who Interview: Richard Edwards

Richard Edwards is Chief Program Officer at Community Based Care, LLC
Check out his LinkedIn profile HERE.
Which segment of the industry are you currently involved?

Community Based Care and its family of providers serve people who have long-term service and support needs, primarily with intellectual and/or developmental disabilities, most often through Home and Community Based Services.

 How many years have you been in the Medicaid industry?

I’ve been in behavioral health, broadly speaking, since 1995 — mostly as a member of provider organizations.

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

Within the industry, I’m especially interested in the balance between the civil rights origins of our field — deinstitutionalization; access; reasonable accommodations — and the need to integrate with healthcare systems and models of care. We have — especially since deinstitutionalization — built habilitation and community integration into the Medicaid system, and in some very significant ways, it has never been a perfect fit, because of the influence of the medical model over healthcare funding structures. The fee-for-service reimbursement system is a good example: a procedure or service or medication might address a symptom, but it does not make us healthy. Extending that concept, being healthy is a goal, but it is not the only or even the ultimate goal. Better health provides a foundation on which other quality of life pillars can be built. We seek to aid people in achieving their best possible health so that they can have an improved quality of life. Public funding sources like Medicaid, in this sense, help people with extraordinary challenges do very ordinary things that most people — including me — take for granted. That is what keeps me coming back to this work.

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

Outside of work, seeing the Northern Lights. Something I haven’t done.

What do you enjoy doing most with your personal time?

I am happily married with two amazing daughters — spending time with my family is very important to me. If we can be outside together — that’s a perfect afternoon.

Who is your favorite historical figure and why?

Difficult question, but I would say Martin Luther King Jr. — a prophet for our times, speaking to the most difficult issues of our culture. To borrow several phrases, his words leave you with no defense; his actions bent the arc of history. His life, speeches, and writings have had a permanent effect on how we talk and think about racism, prejudice, and discrimination.

What is your favorite junk food?

Peanut M&Ms. I can’t (won’t) walk past a bowl without grabbing a handful.

Of what accomplishment are you most proud?

There isn’t anything in my career, or my life, that I have accomplished on my own, so it feels a little awkward to say “proud”. I think my greatest accomplishments are still ahead of me. And, even then, I am sure I will benefit from a lot of help.

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

 Only one? The good news in life and work is there will always be more tests to bring your average up — if you take the time to assess and learn from your mistakes. If I had to pick one, not the biggest mistake I ever made, but just stupid on purpose…I once spouted off to a friend over email — commiserating with her about a workplace change that I knew there were multiple sides to, but, we were old friends, and I was just trying to be sympathetic. That email got forwarded (inadvertently) to my supervisor who was, in part, responsible for the change, and who took my jerky comments very personally. I caused a lot of pain with my thoughtlessness, to someone whom I very much respected. I learned several lessons on that one. Years later, I’m still sorry about it.

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

Addressing constitutionality questions about the ACA will drive activity at the state levels where expansion is still in discussion. In my home state of NC, for instance, there is a lot of interest across the political spectrum in expanding Medicaid, in some limited fashion, but questions about the status of the ACA could delay any serious conversation. Success/failure of new models — like the I/DD Health Home model in NY — to address integrating healthcare and long-term services and supports for people with I/DD. Some of these models are very promising but combining these two practices has always been harder than it looks. While these models are new and should be given time to mature, I think their viability will be evident sooner than later.


Know someone in the space who’s doing great work and is an all around interesting person?
Send a note to to nominate them for the next round of Medicaid Industry Who’s Who Interviews.