Episode Description:
In this episode, Rachel sits down with Josephine Wilton, Principal Consultant at Hullanta Consulting, to dive deep into the operational realities of implementing value-based care. They discuss the challenges organizations face in aligning data, staff, and financial models, and how smaller practices and solo practitioners navigate these complex systems. Josephine shares actionable strategies for bridging the gap between theoretical value-based models and real-world execution.

Rachel and Josephine had so much to cover that they'll be back next week to continue the conversation, exploring even more practical solutions and lessons learned from both providers and payers.

Timestamped Highlights:

1. 0:52–4:28 – Introduction of Josephine Wilton and her expertise in operationalizing value-based care.

2. 5:04–7:40 – Early contracting stages and the importance of communication between providers and payers.

3. 10:15–12:27 – Why operational and clinical teams must be involved early in negotiations.

4. 13:30–16:23 – Challenges faced by solo practitioners and smaller organizations in value-based care.

5. 18:32–21:36 – Importance of real-time data and the delays that can impact value-based programs.

6. 26:25–28:24 – Friction points in attribution, performance metrics, and total cost of care.

Key Topics Discussed:

• Value-based care models vs. fee-for-service systems

• Operational and clinical alignment during contract negotiation

• The critical role of real-time data in decision-making

• Challenges for small and solo practices

• Understanding total cost of care and outcomes measurement

Main Takeaways:

• Early involvement of clinical and operations teams is crucial to success.

• Real-time data access is necessary to track performance and guide decisions.

• Smaller organizations may have agility but require support with modeling and analytics.

• Clear communication between providers and payers prevents misalignment and frustration.

• Understanding both baseline and value-based payment structures is essential before execution.

Resources Mentioned:

• Implementing Value-Based Care, a Scoping Review

• Value-Based State-Directed Payments in Medicaid, Feb 2023–May 2024

• Why Primary Care Practitioners Aren't Joining Value-Based Care Payment Models

Connect with the Guest:

• Josephine Wilton, Hullanta Consulting

Connect with The Mental Health Evolution:

• Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast

• Instagram: @mentalhealthevolution

• LinkedIn: Mental Health Evolution

• Facebook: Mental Health Evolution

Music by Zach Harrison

• 00:03 – Introduction to Matthew Stone and overview of episode
• 06:10 – Discussion on the increase in student mental health needs post-COVID
• 11:03 – Overview of federal grant shifts and funding uncertainty
• 14:07 – Impact of grant terminations on hiring and staffing
• 19:01 – Focus on school psychologists and narrowing of grants
• 25:38 – Implications for districts trying to fulfill local needs

• COVID's impact on student mental health
• Federal grant programs for school mental health
• Policy changes and administrative priorities
• Workforce challenges: counselors, social workers, and psychologists
• Local district strategies for sustaining services

• Student mental health needs have increased, exacerbated by COVID
• Policy changes and grant terminations create uncertainty for districts
• Narrowing grants to school psychologists may limit local flexibility
• States and districts are developing innovative strategies to meet needs
• Sustaining mental health services requires planning beyond federal funding

• "I think the focus on school psychologists has stumped a lot of people in the mental health world."
• "Schools are navigating unprecedented changes while trying to provide consistent support to students."

• KFF: The Landscape of School-Based Mental Health Services
• US House Press Release: Fitzpatrick Leads Bipartisan Coalition
• Education Week: Trump Admin Relaunches School Mental Health Grants

For this week's episode, I was excited to welcome Dr. Dylan Ross, PhD, LMFT, LPCC, Head of Clinical at Blueprint AI and a nationally recognized leader in behavioral healthcare, clinical innovation, and measurement-based care. Dr. Ross brings a wealth of experience from his leadership roles at Optum, Rogers Behavioral Health, and Kaiser Permanente, where he shaped clinical strategy, digital innovation, and measurement-informed care frameworks. He currently chairs the American Psychological Association's National Advisory Committee for Measurement-Based Care, guiding national strategy on standardized clinical measurement protocols.

In this conversation, Dr. Ross shares insights on measurement-based care (MBC), value-based care, and how AI can support clinicians without replacing clinical judgment. We discuss how integrating patient-reported outcomes into routine practice improves clinical efficiency, therapeutic alliance, and outcomes, while also addressing workforce challenges and administrative burden. He also highlights Blueprint's AI-driven tools that save clinicians time, enhance care delivery, and enable real-time insights to support patient care.

0:03 – Introduction to Dr. Dylan Ross, his background in behavioral health, and his current role at Blueprint AI
4:08 – Dr. Ross shares his career journey from Kaiser Permanente to Optum, Rogers Behavioral Health, and Blueprint AI
9:27 – Explaining measurement-based care (MBC): definition, benefits, and impact on treatment outcomes
16:02 – Adoption rates and challenges of MBC in behavioral health, including clinician and patient engagement
17:42 – Value-based care: evolution, payer perspectives, and how outcomes drive reimbursement
27:17 – How AI supports clinicians: reducing administrative burden, increasing MBC adoption, and providing real-time session insights
34:25 – Call to action for the behavioral health system: workforce preparedness, aligned incentives, and systemic improvements

• Value-Based Care: What It Is, and Why It's Needed — Commonwealth Fund

• Getting on Board with Measurement: Implementing Measurement-Informed Mental Health Care — Institute for Healthcare Improvement (IHI)

• AI in Behavioral Health Documentation: Ethical Considerations for Mental Health Clinicians — Blueprint AI Blog

• Website: Blueprint AI

• LinkedIn: Dylan Ross

• Website: The Mental Health Evolution

• Instagram: @thementalhealthevolution

• LinkedIn: The Mental Health Evolution

• Facebook: The Mental Health Entrepreneur

Music by Zach Harrison