Category: Technology

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Medicaid Who’s Who Interview: Paul Brasler

Check out his LinkedIn profile HERE.

Which segment of the industry are you currently involved?

I am a licensed clinical social worker and have been working directly for Medicaid for a year. Prior to this, I was a clinical provider working with clients with Medicaid in a variety of settings. My current role is the Behavioral Health Addiction Specialist for the SUPPORT Grant Team at the Department of Medical Assistance Services (Virginia Medicaid) and I provide training and technical assistance to providers working with clients with substance use disorder and co-occurring disorders.  

How many years have you been in the Medicaid industry?

Directly, one year; since 2002 as a provider.   

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

My primary focus is working with high risk clients, especially people living with SUD and/or mental health issues. There are far too few clinicians who are trained to work with people in crisis; our formal educational institutions do not provide the necessary education to future social workers, counselors and medical providers to engage the most vulnerable members of society. My passion therefore lies in teaching and writing and high risk clients. I published a book, 

High Risk Clients: Evidence-based Assessment & Clinical Tools to Recognize and Effectively Respond to Mental Health Crisis (PESI Publishing & Media, 2019) to try and address the need to expand this knowledge base .

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

To publish a comprehensive text on substance use disorder and SUD treatment.​

What do you enjoy doing most with your personal time?

Spending time with my family—my wife and our three boys, preferably outside. This includes hiking, swimming, camping, working in the gardening. I also run a fair amount and play the electric bass. 

Who is your favorite historical figure and why?

Jerry Garcia, musician, writer and filmmaker. He was a very complex person who shaped much of modern American music. What’s most interesting about him is that his bandmates in the Grateful Dead saw him as a leader, and yet he refused to lead. But the way he embraced different types of music is just incredible. 

What is your favorite junk food?

Ice-cream  

Of what accomplishment are you most proud?

Being a dad and a husband. Nothing else comes close. 

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

I wish I had taken the opportunity to travel more when I was younger. 

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

  1.  We have to end the COVID 19 pandemic, and this can only be done by encouraging people to get vaccinated 
  2. Addressing the ongoing substance use crisis (it’s not just opioids). This means looking at ways to reduce barriers to treatment and finding ways to expand the quantity and quality of treatment providers, especially in rural areas
  3. Medicaid’s goal should be to help clients get off of Medicaid and onto an employer funded insurance plan. The best way to further equality and opportunity is through employment opportunities for people, we have seen this historically. Most of my clients want to work and they realize how much better they do in their recovery when they are working. Medicaid should be a stepping stone not an end 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: Jodi Patton

Jodi Patton is the Head of Payer Operations at Hazel Health  

Check out her LinkedIn profile HERE.

Which segment of the industry are you currently involved?

I am currently working in the healthcare delivery segment, providing direct pediatric physical health services via telehealth in both school and at home. My primary focus is on the collaboration with Medicaid payers to support Medicaid eligible populations in accessing care where they feel safe and supported and to close gaps in care. We work to provide a seamless integration between children, the healthcare system and education by adapting and working to find solutions.

How many years have you been in the Medicaid industry?

I have been working both directly and indirectly in the Medicaid industry for the past 6years. My initial experience with the Medicaid was as a case manager for both the geriatric population and for children with Autism Spectrum Disorder. I was able to experience first-hand the complexity of delivering care within these populations and eventually worked at Nevada Medicaid. I started my tenure at the State as a policy and program specialist within medical programs and eventually served as Chief. During my tenure, I was able to successfully work with CMS to change our State Plan for free care reversal and tribal FQHCs. This work was incredibly rewarding and working with Hazel has allowed me to have the opportunity to work on the implementation side of the school-based policies.

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

I am passionate about bringing equity in healthcare and education to children. I am so fortunate that my career is aligned with my passion. I grew up in an impoverished area in Las Vegas and I have witnessed first had the impact that this can have. As leaders in the industry, we must truly keep a keen eye on how to make the lives of our future generation better.

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

Post pandemic, my bucket list will be filled with travel and new experiences. Since that is not feasible at the moment, I have been focused on traversing as many trails as possible around Lake Tahoe where I reside.  There are a lot of incredible hikes, lakes and wildflowers to see in the area and I don’t want to look back with regret that I didn’t make the most of them. I think right now there is so much value in finding pleasure in the moment and slowing down just a bit.

What do you enjoy doing most with your personal time?

Most of all, I enjoy my family. I have four incredible daughters and a granddaughter. They bring so much joy and insight into my life. Time spent with them is invaluable. I also really enjoy being active and I read all the time. I like my personal time to be a place of growth and exploration.

Who is your favorite historical figure and why?

That’s a tie between Maya Angelou and Rosa Parks. I admire Maya’s clarity of thought and inspiration that she brings to the world. Rosa had so much courage in the face of adversity and made such an impact during the civil rights movement. Both women came up through adversity and made changes to the world. They are both heroes.

What is your favorite junk food?

Ice cream. Hands down. I love all of the unique flavors and artisanal approaches. Growing up in an Italian family, spumoni would be my all-time favorite. I loved going to Thrifty as a kid and getting the cool cylindrical shaped scoops of butter pecan. We didn’t have much money growing up, but we could always scrape out the15 cents for a scoop. These are such strong, happy memories from my childhood. I just always remember laughing and life feeling perfect in these moments.

Of what accomplishment are you most proud?

I am incredibly proud of my four daughters. They provide more meaning and value in my life than anything. I continually try to carve a path so that they will have amazing futures. I just finished my second master’s degree in six years, both with a 4.0 and honors and working full time. I have to admit I am proud of that accomplish as well. Education and knowledge are so incredibly valuable and a gift not to be taken lightly.

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

Honestly, I don’t want any mulligans. I have learned more from my mistakes even when they are painful and I wish there was a do-over. It’s the ability to be scrappy, pull it together and move forward that builds your character and resistance. It’s all about progress. I gave up trying to be perfect a long time ago.

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

The importance of Medicaid is more critical and even more complex than ever right now. We are going to see a surge in enrollments amidst budget cuts and changing methods of healthcare delivery. We are going to have to be thoughtful in our approaches and work together in truly addressing the needs of our communities. This is not a time of self-serving interests, but to be givers and not takers. We will need to be mindful in our approaches of supporting healthcare business practices while ensuring that recipients are able to receive the care they need. We will need to move and change quickly but with intelligence and think outside of the standard ways of delivering Medicaid services. 

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: Robert Darzynkiewicz

Robert Darzynkiewicz is the Chief Medical Officer at Hazel Health  

Check out his LinkedIn profile HERE.

Which segment of the industry are you currently involved?

Telemedicine. Specifically school based telemedicine. 

How many years have you been in the Medicaid industry?

Since my training started in the Bronx. 21 years.

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

To leverage technology to provide quality care to families who need it the most. 

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

Go fly fishing in the South Pacific Ocean.

What do you enjoy doing most with your personal time?

Spending it with my family. I have 2 daughters, one going to college this year and another one close behind. I am treasuring the few years I have before they leave our home. 

Who is your favorite historical figure and why?

Martin Luther King Jr. A man who changed civil rights through peaceful disobedience. That took truly amazing courage.  

What is your favorite junk food?

Nachos with all the toppings and extra jalapeños. It doesn’t qualify as ‘junk’ but I can’t validate it as an everyday meal.

Of what accomplishment are you most proud?

Raising 2 smart, motivated young women who want to make their community better. 

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

US Swimming Olympic Trials in1996. I was seeded 4th going into finals and let the pressure of the moment get to me. I wish I just enjoyed the moment instead of worrying about failure. 

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

Discovering what high quality of care was delivered during the pandemic. How did telemedicine help Medicaid patients. What are the most glaring social injustices and medical gaps that were exposed for Medicaid patients and their families.

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: Stuart Rabinowitz

Stuart Rabinowitz is the Chief Technology Officer at ARC Healthcare

Check out his LinkedIn profile HERE.

Which segment of the industry are you currently involved?

Here at ARC Healthcare, we focus on supporting the payers and providers, in addition to building robust and expandable physician networks. We help to build networks and identify areas in need of physicians. We then define them, vet them, get them onboard, and then we negotiate with them. We ensure that the Payers (i.e., Medicaid) and patients have access to adequate and quality care.

How many years have you been in the Medicaid industry?

I have been in healthcare, including some Medicaid projects, for 15+ years.

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

My biggest passion is enabling patients and providers with the right information to make good sound decisions and to understand those decisions. Another passion is resolving the information disparity.  The information disparity occur when patients and providers do not have the relevant information necessary to make healthcare decisions.

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

Helping patients and providers understand diagnoses and treatment options. Therefore, having the right information to make the right healthcare decision is necessary.

What do you enjoy doing most with your personal time?

I play the bagpipes and like to spend time outdoors with our dogs.

Who is your favorite historical figure and why?

Copernicus. He was one of the first scientists to use measurable data to argue a controversial point – the world isn’t flat.

What is your favorite junk food?

Oh, that’s easy! Jellybeans and red licorice.

Of what accomplishment are you most proud?

My three children. I am proud of a bunch of things, but I think I’m most proud of my children.

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

I don’t look back. I always reflect on mistakes and whatever, but there is nothing that I would say I would go back and re-do. I would learn from it and try not to repeat that mistake.

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

I think there is going to be a massive issue of how to provide medical coverage and provide services post-COVID-19. We are seeing lots of folks being laid off and losing their health insurance, so, naturally, you are going to see spikes in Medicaid enrollment. The primary question is, how do you provide coverage to those new enrollees, and then how do you ensure access to care? How will we ensure that our Medicaid networks can handle the increase of new enrollees and provide the quality of care that new enrollees are going to need?

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: 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