Episode Description:
In this second part of her conversation with Josephine Wilton, Chief Strategy Officer at Hullanta Consulting, Rachel dives deeper into the complexities of value-based care. Josephine draws on decades of experience in managed care strategy, population health, and contract design to explore why these models often feel difficult to implement.

This episode examines the operational realities behind value-based care, including the importance of utilization data, the impact of contracts on organizational performance, and the necessity of interdisciplinary collaboration. Listeners will gain actionable insights on how to navigate these challenges, advocate for their teams, and optimize care delivery in a system that is constantly evolving.

Key Topics Discussed:

• Understanding the impact of value-based payment measures on provider organizations

• Why utilization data is critical for telling your organization's story

• Contract design and its influence on revenue, operations, and organizational outcomes

• Engaging specialists and ancillary providers in value-based care

• The role of social determinants of health in patient outcomes and reimbursement

• Strategies for data-driven decision-making and negotiating with health plans

Main Takeaways:

• Ownership of your data is essential — know your utilization metrics and communicate your story clearly

• Value-based care cannot succeed with primary care alone; specialists and ancillary providers must be included

• Contracts influence all parts of an organization, not just payment; thorough review is critical

• Collaboration across disciplines and sharing actionable data drives better outcomes

• Advocating for your organization requires persistence and strategic negotiation with health plans

Notable Quotes:

• "So it's very incumbent upon you to tell your story in your way. Don't let someone else tell your story." — Josephine Wilton

• "Primary care cannot do it alone. You need cardiology, endocrinology, podiatry, everyone involved, and they typically haven't so they're contributing to the total cost. They're seeing different needs of the patients than the other providers." — Josephine Wilton

Resources Mentioned:

• National Committee for Quality Assurance (NCQA)

• Centers for Medicare & Medicaid Services (CMS)

• National Academy for State Health Policy

• Milliman

Connect with the Guest:
Josephine Wilton, MHA
Chief Strategy Officer, Hullanta Consulting
hullantaconsulting.com

Connect with The Mental Health Evolution:

• Website: mentalhealthevolution.com

• Instagram: @mentalhealthevolution

• LinkedIn: Mental Health Evolution Podcast

• Facebook: Mental Health Evolution Podcast

Music Credit: Music by Zach Harrison

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