Governance Model For Scale: The Centerstone Case Study

September 25, 2025

1:00 – 2:00 pm ET

Choosing a governance model for a provider organization, which outlines how the organization is managed, the responsibilities of its leaders, and how decisions are made, is fundamental to any success the organization is expected to have. This model is the framework that ensures the organization operates ethically, effectively, and sustainably.

During this one-hour live event, David Guth, Chief Executive Officer of Centerstone of America and Paul Duck, OPEN MINDS Chief Strategy Officer, will explore the leadership and governance strategies behind one of the nation’s largest non-profit behavioral health providers—Centerstone. Through an in-depth interview, they will examine how a clear and scalable governance model can enable sustained organizational growth, support mission integrity, and support executives and staff in navigating the complexities of operating in multiple states and payer systems.

The conversation will trace Centerstone’s journey from a regional provider to a national behavioral health powerhouse, focusing on how the governance model was intentionally designed—and continuously refined—to support scale. It will discuss the core elements of Centerstone’s structure, including the balance between centralized strategy and localized execution, the role of the corporate board and subsidiary boards, and how leadership accountability and alignment are maintained across a geographically diverse footprint.

Mr. Guth will share lessons learned over his multi-decade leadership tenure, including how Centerstone has managed organizational integration through mergers and affiliations, preserved clinical quality during rapid growth, and positioned the organization to succeed in value-based care and managed care environments.

Executive attendees of this session will:

Understand how a scalable governance structure can support sustainable organizational growth and system-wide alignment.
Identify the key components of Centerstone’s governance model, including strategies for maintaining local responsiveness while advancing a national strategy.
Gain practical insights on how to structure leadership, boards, and accountability mechanisms to successfully manage growth, maintain culture, and ensure quality across multiple entities or regions.

Featured Speakers

David Guth, Chief Executive Officer & Co-Founder, Centerstone

David Guth is Chief Executive Officer and co-founder of Centerstone, one of the nation’s largest behavioral health care providers. With over 40 years of behavioral health care experience, his experience and expertise encompass a vast number of areas, both business and clinical. He has presented extensively before national and international audiences on the adoption of information technology in the health care industry, the integration of behavioral and primary health care, and the importance of improving the field of behavioral health through research-driven protocols. His insights on these topics and others have been featured in numerous professional journals. Under his leadership, the organization has grown from $6 million in revenues and 300 staff serving 2,000 individuals to revenues of more than $300 million and more than 5,000 staff serving nearly 180,000 people each year through partnership locations and more than 200 facilities. In addition, Centerstone contracts with over 700 specialty credentialed clinicians nationwide.
Paul M. Duck, Chief Strategy Officer, OPEN MINDS

Paul M. Duck brings over 30 years of experience in leadership and management focusing on managed care, health information technology organizations, strategy, business development, and market expansion, and customer experience optimization to the OPEN MINDS team. Prior to joining OPEN MINDS, Mr. Duck served as the Vice President, Strategy & Development at Beacon Health Options. In this role, Mr. Duck led the organization’s strategy and business development efforts–responsible for a 30% increase in net revenue and initiated over $1 billion in revenue generation. Mr. Duck was active in national behavioral health initiatives as an executive of Beacon Health Options, including participating as a speaker at national and state association meetings.

Registration is free and requires an OPEN MINDS Circle account, which you consent to OPEN MINDS creating on your behalf if one does not exist. For access to the full line of market intelligence including executive briefings, industry news, state and organizational profiles, RFPs, and datasets from the specialty health and human services market contact us at 855-559-6827 or info@openminds.com to become an OPEN MINDS member.