Going Beyond ‘Checking the Boxes’: Blue Cross Blue Shield Minnesota Names New VP of Mental Health Parity

Behavioral health parity is a critical issue for providers, payers, clinicians and patients. One payer is taking a strong stance by creating an executive role focused on parity.

Blue Cross Blue Shield of Minnesota named Brett Hart its new vice president of behavioral health and mental health parity. This is a new position for the payer and may set a standard for other insurers to follow.

The creation of this job description demonstrates a commitment to the “spirit of parity,” according to Hart.


Hart most recently served as chief operating officer for medical strategy at managed care organization Centene. He previously held the titles of chief behavioral health officer at Centene and vice president of national operations at Optum.

Blue Cross Blue Shield of Minnesota covers 2.5 million members, located in every Minnesota county, all 50 states and on four continents.

Behavioral Health Business sat down with Brett Hart to discuss the new role, parity and going beyond “checking the boxes.”


This interview has been edited for length and clarity.

BHB: Tell me about your background. How has your experience, particularly at Centene, prepared you for this role?

Hart: It was a combination of experiences over time. I started my career as a clinical psychologist. I spent a fair amount of time working in hospital and clinic settings, which helped me understand more about the health delivery ecosystem and how we can collaborate to improve care. That experience also gave me an appreciation for the criticality of medical behavioral integration.

I was first exposed to parity work at Optum and in 2008 when The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (MHPAEA) was first passed. I helped the organization align itself appropriately to be parity-compliant.

My experience with Centene was heavily focused on leading and restructuring the behavioral health organization to best deliver on our priorities we had especially to underserved populations, making care easier to access and more effective and timely.

What does parity mean to you?

Parity is about consistency in how behavioral and physical health conditions are covered and benefits are administered. Probably for years to come, regulators, payers, providers and advocacy groups will continue to refine all the facets of parity, how they’re measured, how compliance is demonstrated and so forth. That’s one aspect of parity.

On a broader level, I think parity, at its core, is really about recognizing the criticality of behavioral health. It’s about removing barriers to behavioral health care, facilitating the highest-quality care, and making sure cost and benefit design don’t become barriers. It’s about making sure people can access care and that they’re not going to be treated differently because they have, for example, depression versus blood pressure.

This is a brand-new title for Blue Cross Blue Shield Minnesota, so I assume the job description will evolve over time. As it stands, what will this role entail?

Most foundationally the role is about creating a very powerful behavioral health capability that can be leveraged to advance all aspects of the services we deliver.

It’s important to have someone who can ensure that behavioral health has a clearly defined seat at the table. It’s also important for a role like this to define a clear strategy and drive it forward and collaborate with internal and external stakeholders to make sure that we’re creating the best outcomes for our members by addressing their behavioral health needs in the context of total health and well-being.

Connecting parity to a leadership title is unusual. What do you think about this new role?

I thought it was especially insightful and forward-looking for Blue Cross Blue Shield of Minnesota to connect parity to this role. When you look at behavioral health roles in the payer arena, you don’t often see them connected with the term parity.

I thought it was a brilliant move on the part of Blue Cross Blue Shield to connect parity with behavioral health in terms of a leadership role. It can sometimes be a default mechanism to view parity as strictly a legal and compliance exercise. That’s why oftentimes, you’ll find that that term and that role connected somewhere else in an organization, but we really have to remind ourselves that the spirit of parity is to ensure that the criticality of behavioral health is the same level as other health care services.

Having a behavioral health clinician leader, helping drive and ensure that spirit of parity in collaboration with the more technical legal and compliance aspects to me is fundamental.

Do you think other payers will create roles like this one?

I hope so. This is where Blue Cross Blue Shield Minnesota is really leading the industry. I was drawn to it because it’s doing something that currently I don’t think you’re seeing in the payer space, but which I hope other payers begin to adopt.

As a payer, you can address parity in the context of the legal compliance environment, you can check all the right boxes, demonstrate all the right proof points and say that you’ve done your job, but I go back to the real spirit of parity. Are you capturing that? Personally, I think it’s possible to check all the right boxes but still not achieve the spirit of what parity is all about. That’s where I think that behavioral health leadership comes into play in helping to drive beyond the checking of the boxes to determine if we are really achieving the components that are going to allow people to thrive and achieve the highest quality care in the most timely manner.