OPEN MINDS Announces Executive Roundtable On Value-Based Care Featuring Sunshine Health’s Carole Matyas
Gettysburg, Pa. (November 17, 2024) On December 12, 2024, at 1 p.m. ET, Carole Matyas, Vice President of Sunshine Health, a Centene health plan, will present the Centene total cost of care model during the OPEN MINDS Circle Elite Executive Roundtable, Value-Based Care For Consumers With Behavioral Health Disorders: A Sunshine Health Plan Case Study.
This advanced integrated care model combines specific accountability (both clinical and financial) for consumers with the delivery of behavioral health and primary care services. It assigns responsibility for the management of specific consumers to provider organization partners that can address their behavioral health, primary care, and social service needs.
Ms. Matyas will discuss how Sunshine Health is contracting this model in Florida, including the challenges of advanced health plan/provider partnerships and the future of these partnership relationships in a changing health care environment. This live session will be moderated by OPEN MINDS chief executive officer, Monica E. Oss, and will include the opportunity to ask questions.
“In a health care landscape with increasing price and cost sensitivity at all levels, there is a need for financial alignment around value,” said OPEN MINDS Chief Executive Officer, Monica E. Oss. “Executives of specialty organizations need a strategy that can protect their market share with high-risk, high-needs consumers and the ability to work with health plans in an integrated care environment.”
Executive attendees of this session will understand:
- The health plan driver for changing the model.
- The key elements in an advanced model to manage cost of care.
- What the future looks like for this integrated care model.
To register for the 1:00 p.m. ET, December 12 event, visit https://attendee.gotowebinar.com/register/1374947429894373465. There is no cost to register, but a free membership in the OPEN MINDS Circle is required.
Speaker Bios
Carole Matyas, Vice President of Sunshine Health, a Centene health plan
Carole Matyas is the Vice President Operations for Sunshine Health Plan. She oversees the SMI Specialty Plan in Florida and has responsibility for overall operation of the program. Carole is accountable to assure the development of a fully integrated medical/behavioral program that is centered in whole person attention and care. She assists with representing the company externally to assure our members, providers and stakeholders have the information and support they need. Carole has more than 30 years of behavioral health-related experience, with 20 years of experience in health plan operations. She joined WellCare in 2011 as VP Behavioral Health Operations at WellCare Corporate office. Previously she worked for Magellan Health Services, first as a general manager for call center operations, and then as Chief of Clinic Operations, where she led practice management and operations of 23 mental health clinics and a psychiatric urgent care center in Arizona. Her additional experience includes serving as Vice President of Public Sector Operations for Schaller Anderson, a Medicaid managed care organization and helped to develop their integrated model; and as Vice President for Value Options, a managed behavioral health care company whose contracts included carve out managed care for state and government agencies, where Carole was executive lead on a large carve out program in Texas. Carole spent her early career as a licensed social worker providing direct clinical services in a group practice, community mental health and a residential treatment center. Carole has been recognized by Mental Health America and NAMI Texas for her dedication to mental health advocacy. Carole earned both her undergraduate and Master of Social Work degrees from Marywood University in Scranton, Pennsylvania.
Monica E. Oss, Chief Executive Officer, OPEN MINDS
Monica E. Oss, M.S. is the founder of OPEN MINDS and serves as its chief executive officer, executive editor of its publications and web sites, and executive lead of its consulting engagements. For the past three decades, Ms. Oss has led the OPEN MINDS team and its research on health and human service market trends and its national consulting practice. She is well known for her numerous books and articles focused on the strategic and marketing implications of the evolving health and human service field – and its focus on the verticals of the field serving consumers with chronic conditions and complex support needs. Ms. Oss has extensive experience in developing and implementing growth strategies for a wide array of organizations in the field. She has expertise in industry trend analysis, in reimbursement and rate setting, and creating actionable plans for market success. In her role, she has led numerous engagements with state Medicaid plans, county governments, private insurers and health plans, service provider organizations, technology vendors, neurotechnology and pharmaceutical organizations, and investment banking firms – with a focus on the implications of financing changes on delivery system design.