Rachel speaks with Nicole Sartini, a licensed clinician, group practice owner, and founder of Build Better Health — a nonprofit think tank that is building the kind of collective provider power that this field has been missing.

Nicole came to advocacy the way most providers do: through her own practice. In 2024, after ten years of building Bridge Counseling and Wellness into a 60-provider group practice in Louisville, Kentucky, she watched insurance carve-outs and contract repairing cut her practice's income by 30 percent for the same number of sessions. She started organizing locally — monthly meetings, surveys, conversations with the Kentucky Department of Insurance — and discovered something that stopped her in her tracks: the laws protecting providers from exactly this kind of harm already existed. They just had no teeth to enforce them.

What started as a small Kentucky organizing effort has grown into a 50-state coalition with 4,000 providers directly participating. The Mental Health Insurance Reform Task Force is now structured around state-specific pages, state leads, and three national committees — Education, Innovation, and Legal and Legislative — with a team of attorneys tracking litigation opportunities and model legislation based on successful wins in states like Illinois, where HB1085 connected the reimbursement floor to the Medicare rate and raised commercial insurance rates for providers by approximately 30 percent.

The conversation covers the two pillars of the Task Force's work: enforcing parity law, and protecting provider independence as insurers and behavioral health platforms consolidate. Nicole walks Rachel through what vertical consolidation actually looks like on the ground — providers being required to credential through third-party platforms to access major insurers, charts being pulled when providers leave, and data concerns that have no adequate legal framework yet. She also shares the Progressive Advocacy Ladder, a step-by-step framework that tells providers and state leads exactly where their state stands and what the next achievable step looks like. And she closes with an invitation: the Task Force meets the second Wednesday of every month at 11am Eastern — and everyone is welcome.

Resources Mentioned

Articles Referenced:

• Trump Administration Puts Its Stamp on Mental Health Parity — Mercer (2026): https://www.mercer.com/en-us/insights/us-health-news/trump-administration-puts-its-stamp-on-mental-health-parity/
• What Plan Sponsors Need to Know: 2025 Mental Health Parity Report to Congress — Sequoia (May 2026): https://www.sequoia.com/2026/05/mental-health-parity-2025-report/
• Behavioral Healthcare Services Market Update — Capstone Partners (March 2026): https://www.capstonepartners.com/insights/article-behavioral-healthcare-services-market-update/
• Progressive Advocacy Ladder and National Strategy — Mental Health Insurance Reform Task Force: https://insurancereformtaskforce.org

Connect with Nicole Sartini:

• Mental Health Insurance Reform Task Force: https://insurancereformtaskforce.org
• Build Better Health: https://buildbetterhealth.org
• Monthly meetings: Second Wednesday of every month, 11am EDT / 8am PDT

Connect with The Mental Health Evolution:

• Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast
• Instagram: /thementalhealthevolution/
• LinkedIn: /the-mental-health-evolution
• Facebook: /TheMentalHealthEvolution

Music by Zach Harrison

Rachel speaks with Joanne Frederick, founder and CEO of Government Market Strategies, about something most clinicians never see but feel every single day — the procurement decisions, ownership structures, and administrative design choices that determine who gets credentialed, who gets paid, and who gets left out.

Joanne has spent more than 30 years on the inside of the largest government healthcare programs in the country — Medicare, Medicaid, TRICARE, and Veterans Health — helping clients win contracts in excess of 25 billion dollars and watching the same patterns play out across every system she has worked in. Her perspective on the CAQH rebrand to DataSpring is not that of a worried clinician. It is that of someone who has seen this move before and knows exactly what it means when the entity governing a shared infrastructure becomes owned by the people who benefit most from controlling it.

The conversation covers the structural conflict of interest created by insurer ownership of the credentialing backbone, why credentialing delays are a revenue problem and a patient access problem as much as an administrative one, and what it would actually take to fix a system that Joanne argues was never designed to serve everyone equitably. She walks Rachel through the TRICARE reforms happening in 2026 and what they reveal about how large government healthcare programs modernize — and don't. And she ends with a call to action that is both practical and urgent: find the people with the courage to say this doesn't make sense anymore, and support them, because they are going to need all the help they can get.

This episode also includes a brief ad read for the Foundations of Trauma Therapy course at the Trauma Specialist Training Institute — an eight-week live remote training starting October 20th. Early bird pricing is available through October 6th. Group rates for teams of five or more are available by emailing info@traumaspecialiststraining.com and mentioning the podcast.

Featured Training
Foundations of Trauma Therapy — Trauma Specialist Training Institute
https://www.traumaspecialiststraining.com/trainings/foundations-trauma-therapy

Resources Mentioned

Articles Referenced:

• CAQH Rebrands as DataSpring: Under Payer Ownership — Acuity News: https://acuity.news/regulation/caqh-rebrands-dataspring-payer-ownership-credentialing-2026/
• 5 Trends Shaping Payer Enrollment and Medical Credentialing in 2026 — Medallion: https://medallion.co/resources/blog/5-trends-shaping-payer-enrollment-and-medical-credentialing-in-2026
• These Changes to TRICARE Plans Are Taking Place in 2026 — Military.com: https://www.military.com/benefits/tricare/these-changes-tricare-plans-are-taking-place-2026.html
• 5 Things We Need To Do To Improve The US Healthcare System — Joanne Frederick, Authority Magazine: https://medium.com/authority-magazine/joanne-frederick-of-government-market-strategies-5-things-we-need-to-do-to-improve-the-us-0dc5ca52aa7a

Connect with Joanne Frederick:

• Government Market Strategies: https://marketstrategiesonline.com

Connect with The Mental Health Evolution:

• Website: https://www.traumaspecialiststraining.com/mental-health-evolution-podcast
• Instagram: /thementalhealthevolution/
• LinkedIn: /the-mental-health-evolution
• Facebook: /TheMentalHealthEvolution

Music by Zach Harrison