The Recovery Executive Podcast

The Recovery Executive Podcast

The business of recovery is changing fast. Many executives are getting left behind. The Recovery Executive Podcast talks to experts in the field on marketing, operations, M&As, billing, and growth to help you build your organization, serve more of those who need help, and stay on top.

Episodes

April 16, 2025 • 62 mins
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,...
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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 negotiat...
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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 pro...
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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...
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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 robu...
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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,...
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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....
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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, ...
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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.
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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.
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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 de...
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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 oper...
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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 buil...
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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...
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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 neurobiol...
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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 wo...
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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.
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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 lo...
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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 accom...
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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 o...
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