When it comes to the nation’s $42 billion dollar substance use disorder (SUD) treatment market, services are naturally the focal point of most businesses. But providers can’t offer those services at scale without the help of payers, who have the power to make treatment more affordable and accessible to the masses.
That’s why Landmark Recovery — a SUD treatment provider with 11 locations across eight states — recently hired Annie Mooney.
As the new vice president of public affairs and payer relations for the Scottsdale, Arizona-based company, Mooney is responsible for engaging with political officials at the municipal, state, tribal and federal levels, as well as working with payers of national, regional and local scale.
In her new post with Landmark, Mooney, a 13-year veteran of Phoenix Children’s Hospital, has her sights set on growth. Specifically, she’s eyeing national contracts and national scale for Landmark, a holding company under Simsbury Associates that currently accepts a mix of commercial insurance plans and Medicaid across its inpatient and outpatient facilities.
Behavioral Health Business recently caught up with Mooney, who discussed the goals she has in her new position, her advocacy priorities and the key role payers will have in Landmark’s plan to add eight locations in five new states over the next 18 months.
You can find BHB’s conversation with Mooney below, edited for length and clarity.
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BHB: Talk to us about your new role at Landmark. What are the responsibilities of your new position?
Mooney: Looking at Landmark’s results, medical professionals, dynamic corporate growth strategy [and] evidence-based treatments… made the organization really attractive to me.
I’ve been brought in to develop the department of public affairs and oversee relationship management with payers. Through public affairs, I will be developing strategic relationships with the business community, [as well as] state-, municipal-, tribal- and federal-elected officials and their staff to help advance the conversation around substance use disorder, access to care and the need for comprehensive insurance coverage.
On the payer relations side, I will be supporting existing contractual relationships and working to increase efficiencies by moving to national contracts. This is especially important as we grow into additional markets. Currently, we’re in eight states with 11 facilities, and our strategic plan over the next 18 months calls for an additional eight sites in five other states.
How would you describe the relationship that addiction treatment providers have with officials at the various levels of government you just mentioned?
I find that coming from the pediatric world, elected officials are very in touch with health care as an overarching issue. But I believe there’s room for education regarding substance use disorder and the differences in treatment types that are available, as well as the number of people who are suffering from addiction. I think that’s really missing from the conversation.
Cultivating champions in the policy world is critical to raising awareness, and the primary importance to me is engaging in previously developed relationships and creating new and strategic ones going forward. [With] substance abuse and behavioral health, having parity to traditional physical health is a priority for me.
Who are Landmark’s payers and do you have plans to add more?
Landmark’s largest payer source is commercial insurance plans. Although Medicaid is a growing segment of our population, with each state having their own plan design and covered benefits, contracting becomes very complicated and cumbersome. As we introduce more facilities, we’ll continue to reach out to all plans so that coverage can be had for everyone seeking treatment, whether it’s commercial or Medicaid.
In your view, how receptive have payers traditionally been as far as engaging with addiction treatment providers?
Payers operating in states that have been most severely impacted by the opioid crisis and the economic downturn [have] been the easiest to work with. They have sought alternative payment arrangements, such as value-based reimbursements, for meeting or exceeding set outcome metrics. Others still have a ways to go to see substance abuse treatment as a need, not as an outlying condition.
For me personally working with plans, I’ve had very good relationships. Behavioral health needs a lot more education around its need, but I absolutely anticipate that our relationships are going to remain solid.
Behavioral health and addiction treatment is becoming more regionalized based on states that have more addiction problems. Over time, what will help us will be to have national contracts so that we’re not chasing each and every individual plan and continually having the same discussions about rates.
My hope is that we can move to those national contracts and find something perhaps similar that we can do with Medicaid so that we don’t have to continue to go to each and every state.
Are you hopeful that could happen relatively soon? Or do you think more work needs to be done in that regard?
Larger payers are sophisticated and have the ability to do national contracts. I think it’s the smaller, more regional insurance companies that are not there yet.
Everyone is recognizing whether it’s for behavioral health or physical health, that scale is really important because this is such a fast moving and ever-changing environment. We all need to find ways to be more streamlined.
As you mentioned, your new role deals with public policy and government relationships. What are attitudes like at various levels of government toward the addiction treatment industry in general and Landmark in particular?
Every day, we’re confronted with an escalating number of people facing depression, anxiety, social insecurity [and] acts of violence. We would like to see governments, the business community and the health care system address the root causes that manifest in these experiences.
Landmark Recovery is unique in that [our] treatment focuses on traumatic issues or situations experienced by the patient that have led them to seek a diversion from these seemingly insurmountable and extremely painful events.
The ability to stay sober after treatment is predicated on identifying and addressing personal triggers. Of course, we provide detox and residential treatment. But we go deeper into the root cause of what has brought on the addiction. That makes Landmark very different from other organizations, and we believe that the social challenges that [exist] right now … are just escalating [and] getting elected officials’ attention. I think that we’re going to be poised for a lot more support from the government.
How does your new role factor into Landmark’s overall scale objectives?
Landmark’s growing so rapidly, which is one of the reasons they brought me on board to develop more expansive relationships. The opioid crisis and the addictions that have been realized during COVID mean that access to care must be increased.
[There are] two things that I’m really focused on and believe are important for me to be successful in this role and for Landmark to continue to grow. The first is trust. Being an honest broker of accurate and substantiated information is critical. This is achieved over time and with steady communication, but [is] worth the investment to be a trusted resource.
Secondly, data speaks volumes. Knowing the cost of addiction — whether it’s personal, familial, financial, to a state, a community, a school system [or] an industry — helps folks to understand the need for support and investments in treatments.
You also previously mentioned that Landmark is looking to expand into new states and markets. Have you started having conversations with payers in those prospective markets?
From the real estate bricks-and-mortar perspective, we have projects that are indeed underway. Because we have target dates for opening, we have started to have conversations with the other insurance plans for those areas.
Specifically on the government side, there are a lot of regulatory issues and state and federal laws that need to be adhered to in order to open a new facility. I will be engaging with cities, states, municipalities, tribes [and the] federal government in order to meet those requirements to open new facilities, and to credential our medical professionals.
In your new role, do you see yourself advocating with payers and governments on behalf of the industry, as well as being part of that industrywide conversation apart from what’s going on with Landmark?
I absolutely do. I will be the chief lobbyist for Landmark, and registered as such. We believe that there is so much room and so much need in this industry for more players because the incidence of addiction is only rising. We support and welcome everyone to the table.
At the end of the day, we all have the same objective, and that is to provide lifelong sobriety. Our approaches are different, and we respect and honor that, because everyone who is struggling with substance use disorder requires treatment that fits their lifestyle, their needs [and] their personality.
Landmark happens to be evidence-based and focused on the traumas that brought on the addiction. Other organizations approach it a different way, and so I do believe that there is a great opportunity for us to unite and to address these issues, especially on a federal level or a state level. Together, there’s more power in numbers.
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