About this Event
The past year has seen significant changes in the policy and practices addressing the social determinants of health (SDOH) of health plan members. On the policy side, there have been significant changes at Centers for Medicare & Medicaid Services (CMS) in using a broader array of team members to serve Medicare and Medicaid consumers. And, in response to new CMS guidance, many state Medicaid plans and Medicaid health plans can now pay for a broader range of social services1. The question is how are these policy changes affecting health plan coverage and reimbursement practices?
This webinar focuses on the effects of the recent changes at CMS and the state-specific changes to Medicaid health plans on serving the consumer population with mental illness. In addition to the perspectives of the health plan executive panel, the webinar includes related health plan survey data from the Trends In Behavioral Health Series2.
Listen to this fireside chat with our experts to learn more about how policy changes are causing the creation of new and innovative models for serving consumers with complex needs.
References:
Otsuka Market Access. (2024, August 6). Trends in Behavioral Health: A Reference Guide on the US behavioral health financing & delivery system, 4th Edition. OPEN MINDS. https://payertrends.org/
Centers for Medicare & Medicaid Services. (n.d.). Social drivers of health and health-related social needs. CMS.gov. https://www.cms.gov/priorities/innovation/key-concepts/social-drivers-health-and-health-related-social-needs
Featuring

Sharon Hicks, MBA, MSW, Senior Associate, OPEN MINDS*
Sharon Hicks, MBA, MSW, has more than 35 years of experience in the health and human service field. During that time, she performed a variety of functions, primarily in the public sector mental health market. Her background includes direct care, hospital administration, program administration, health plan management and technology strategy. A recognized thought leader among her peers, Ms. Hicks is a regular keynote speaker at industry conferences and association meetings, as well as an author of hundreds of articles and resources for professionals in both clinical and executive roles.
During her time at OPEN MINDS, Ms. Hicks has served as the interim Chief Information Officer for Community Behavioral Health (CBH), a managed care organization overseeing the Behavioral HealthChoices benefit for all the Medicaid-eligible individuals in Philadelphia County. During this period, the Commonwealth migrated its existing substance use disorder standards and definitions to align with those from the American Society of Addiction Medicine (ASAM). This included new provider roles and new service models. Ms. Hicks was part of the project team at CBH that helped reclassify all the DDAP-licensed providers into the new ASAM categories.
Ms. Hicks received both her Master of Business Administration and Master of Social Work degrees from the University of Pittsburgh in Pittsburgh, Pennsylvania. Before pursuing her graduate education, Ms. Hicks received her bachelor’s degree in Psychology from Point Park College, Pittsburgh, PA.

Margaret Mays, Ph.D., Senior Associate, OPEN MINDS*
Margaret Mays brings over 20 years of health care industry experience to the OPEN MINDS team. Ms. Mays currently serves as a Senior Associate at OPEN MINDS. Her areas of expertise include health plan contracting and reimbursement, quality program design and metrics-based programs, training development, health care processing systems, policy development, and accreditation/regulatory requirements.
Prior to joining the OPEN MINDS team, Dr. Mays served as the Vice President, Staff Accreditation, at Beacon Health Options.
Dr. Mays received a Doctor of Health Sciences from A.T. Still University in Mesa, Arizona. She holds a Master’s degree in Health Administration from the University of Washington. She previously earned a Bachelor of Science in Allied Health Administration from the University of Alabama.

Madeline Shurtleff, Managed Market Liaison, Otsuka America Pharmaceutical, Inc*
Dr. Shurtleff has extensive knowledge in Medicaid and Medicare pharmacy operations and regulatory requirements. Dr. Shurtleff received her Doctor of Pharmacy (PharmD), Business Minor, and Leadership Minor from the University of Rhode Island. She is a licensed pharmacist in Illinois and Arizona.
Speakers Disclaimer:
*Margaret Mays and Sharon Hicks are paid consultants of Otsuka America Pharmaceutical, Inc. (OAPI). Madeline Shurtleff is an employee of OAPI.
*Margaret Mays and Sharon Hicks are paid consultants of Otsuka America Pharmaceutical, Inc. (OAPI). Madeline Shurtleff is an employee of OAPI.
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