Bradford Health Services’ newly minted CEO, Rob Marsh, is no stranger to the behavioral health industry.
Before coming to the substance use provider, Marsh spent the last two and a half years at the helm of 360 Behavioral Health, one of the largest autism providers in the country. His resume also includes stints at some of the largest mental health companies in the U.S., including Acadia Healthcare and UHS.
Marsh is taking on the challenge of SUD care at Bradford, but he said there can be lessons learned from the other parts of behavioral health he can take with him.
Birmingham, Alabama-based Bradford provides substance use disorder (SUD) treatment services in the Southeastern part of the country. It has a network of 40 facilities. Its services include intervention, crisis response, intensive outpatient care, partial hospitalization, residential programs, inpatient detox and transitional and life skill programs.
Addiction Treatment Business sat down with Marsh to discuss Bradford’s growth strategy, value-based care and the company’s top priorities.
This interview has been edited for length and clarity.
BHB: What lessons have you learned from the autism sector that you can take over to the SUD space?
Marsh: One of the things that autism services have going for them is this growing integration of services for the patients. It’s not just the applied behavior analysis (ABA) component; obviously, there’s a lot of speech and occupational therapy and there’s a mental health component.
The type of integration that is happening on the autism side, I’d like to see more on the substance use disorder side. When it comes to mental health, in particular, where that’s such a comorbid.
One of the exciting things about Bradford is that we’ll be able to start expanding into dual diagnosis and making sure that people are being met, where they are, and providing the services. So many SUD providers say mental health, you have to go somewhere else, and Bradford is embracing the idea of doing primary mental health within our substance use disorder programs.
What are some of your top priorities at Bradford?
Bradford is unique in that it offers the full continuum of SUD services, from acute medical and deep supportive detox to sober living and transitional housing. My goal is to expand those services across the entire portfolio into different markets where we’re not offering those specific services.
So, I’m really working to take the continuum and spread it out throughout the entire portfolio and then expand services.
As I mentioned, we are a Southeast regional player. What I’d love to see is expanding services further west and further north and becoming a major player in not just the southeast but also the East Coast or the eastern half of the U.S.
When you talk about expansion, how do you think about it (M&A, de novo growth, etc.)?
We are currently making an effort in de novo and acquisition growth. So we’ve got our eye on two de novo projects that are very exciting to us. We also have several acquisition opportunities in the pipeline.
Since Lee Equity Partners became a sponsor for Bradford about 18 months ago, it has acquired a couple of assets. Those have gone extraordinarily well regarding the integration and our ability to support those facilities. Given that we’ve got a nice playbook for acquisitions, I expect that we’ll do more and more in the near future and into the future.
We talked about the continuum of services before. Are there any types of services that you’re excited about expanding and growing in the near term?
I’m excited about being able to take some of the organs of the spectrum, so the medical-supported detox on one end and the transitional sober living on another, and spread those particular components out into the community and offer those services.
Many programs do detox, but really having that ability to do medical supportive detox and then very few programs actually offer sober living because, frankly, there’s not a lot of money in it. And so it’s got to be something that you’re passionate about and can provide that full continuum. And that’s what Bradford is known for.
Do you see any reimbursement trends shaping the addiction industry, and how can we look at it in the future?
Value-based care is a growing part of substance use disorder reimbursement trends. Here, we already have some value-based contracting that’s done. As we’re looking at these other markets, de novos, and acquisitions, we are actively engaging the payers, specifically from a value-based standpoint. So, I definitely think that’s going to continue as a trend with the payers and reimbursement.
Also, there are lots of other things within the SUD market that are either headwinds or tailwinds. One of them is reimbursement for VA substance use disorder treatment. That’s one of those trends I think we’re all watching where the VA has been a very generous payer, and we’re starting to see that contract and maybe some right sizing when it comes to the reimbursement rates there. So we’re just preparing for that, making sure that we’re ahead of the curve when it comes to what the VA might be doing when it comes to reimbursement.
Value-based care can come in many different forms (ie. risk sharing, value-sharing etc..). What does value-based care mean to you, and what are some of your top priorities?
I think the ideal value-based model has a shared risk for both the payer and the provider. Often, providers go to payers and say, ‘Hey, we’re providing value-based care, and all we want is upside. All we want is the benefits of having these great outcomes and not sharing in the downside when outcomes maybe aren’t what they should be or when there’s a hiccup within the performance.’
I think the right model is that shared risk is associated with services where there’s an upside when all things are hitting and a downside as a disincentive for providers to provide substandard care. You really want to make sure that you’re providing good care, readmission rates are low, and your average length of stay is appropriate given the diagnosis and the complexity of the patient.
