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VALUE-BASED CARE AND POPULATION HEALTHMike Rhoades is the CEO and Founder of Alera Health, the largest manager of specialty behavioral health networks in the USA. Mike has over 30 years’ experience in clinical/executive leadership in behavioral health, primary care, hospitals, and clinically integrated networks. Mike has subject matter expertise in network assemblage and governance, value-based contracting, population health technologies, data analysis, private equity, and public health/behavioral health policy. Mike has led over 20 M&A transactions and served in a variety of executive leadership roles.➢ Expertise in managing large, clinically integrated Accountable Care Organizations within a multi-specialty environment. Intimate knowledge in HIE/CIN data integration and aggregation, population health risk stratification and analytics, care management infrastructure and interventions, and the strategic development of clinically integrated networks. Unique knowledge and experience in behavioral health and PAC integration. ➢ Leadership success translating business models into growth strategy that grew market share and strategically positioned health services organization. Experience managing complex mergers and acquisitions, driving change management and sensitive cultural integrations in matrix environment.➢ Change agent and growth driver with 20-year successful track record building and positioning health care entities for progress. Expert in driving enterprise strategies that maximize organization’s value proposition to medical community and payers while boosting revenue and margins, improving patient care, increasing physician satisfaction, and refining business infrastructure. Clear understanding of legal, regulatory, and political issues/trends in health care.➢ Expert in public policy and advocacy with capacity to build consensus at all levels and drive realistic solutions. Regularly connect with business and healthcare leaders; leverage robust network to drive growth strategies. Able to coordinate, integrate, and influence others outside immediate span of control. ➢ Strengths in finance and investment strategies with full P&L responsibility to complement full range of hands-on managerial and business experience including strategy, financing, operations, sales, and marketing. Requested to sit on multiple entrepreneur boards to provide strategic counsel and guidance.
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CeoAlera Health Feb 2016 - PresentWilmington, Nc, UsAlera Health builds and manages high performance integrated systems of care (ISOCs) that streamline access to coordinated behavioral health, primary care, and social services. Alera Health is a “soup to nuts” population health manager supporting more than 3M patients suffering from behavioral health and medical conditions. -
Managing PartnerW.I.N. Wilmington Investor Network Jun 2003 - PresentFacilitated deal generation, screening, due dilligence, and valuation. Helped coordinate our membership of 75 acreditated investors in reviewing over 50 potential investments each year resulting in an average of 3-6 investments with an annual turnover of $3-5M.
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Adjunct ProfessorUniversity Of Texas At Dallas Naveen Jindall School Of Management Aug 2015 - PresentTeaching Digital Health and Population Health Management. Topics include Population Health, mHealth, Telemedicine, Analytics and Risk Segmentation, Data Aggregation and Security, and Organizational Governance.
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Director, Digital Health And Accountable CareAlixpartners Jul 2014 - May 2016New York, Ny, UsInternational Consulting Firm supporting Fortune 500 firms through complex financial, transition, and technology transitions.Organized and led 7 person team of senior healthcare subject matter experts advising IDN’s, tertiary care, medical device, and pharmaceutical companies on strategies related to payment reform and digital health transformation. Quick-strike projects include consolidating IT platforms for an 8M member multi-state MCO, deployment of a care management/CRG platform for a 150 LTACH system, and development of an inferential risk grouper for an international dental supply/software distributor integrated into practice and supply chain management systems and due diligence for a $500M healthcare analytics company. Comprehensive projects include:• Negotiated the formation of a 75,000 life Clinically Integrated Network spanning 6 hospitals and 140 physicians which successfully negotiated a $748M narrow network contract.• Created and led development of 330,000 life regional Post Acute Care narrow network which supplied advanced care coordination and clinical oversight to LTACH, Skilled Nursing, and Home Health providers via video, HIE, and care management software saving partner ACO’s $32M in the first year. • Developed payment adjudication and audit protocols for program integrity vendor to automate and improve claims surveillance systems realizing $28M in Y1. Project involved EHR data extraction and aggregation, analysis, and workflow integration.• Renegotiated TPA/CMO contracts for 15,000+ life self-insured employers, improving care management resulting in 18% PMPM savings. -
Vp Of Integrative StrategiesCommunity Care Of North Carolina Oct 2012 - Jul 2014Garner, North Carolina, UsLargest multi-payer clinically integrated At-Risk/Shared Savings network in the USA with over 5,000 MD’s, 100 Hospitals, and 2M enrolled patients. Assembled portfolio of CCNC population health knowledge and negotiated with in-house and external technology vendors to package intellectual property in accordance with ACO and health plan customer expectations. Aligned commercial assets with organization strategy and developed business plan to launch a suite of CCNC applications and toolkits that accelerated the development of a maturing ACO to include:• Planned, developed, and negotiated with health systems and independent practitioners in the creation of regional and statewide integrated delivery networks. Led executive and board discussions resulting in a regional payer-provider Coordinated Care Organization around a multi-payer platform (including 30,000 life Medicare Advantage plan).• Organized leaders from the long term care industry and NC DHHS around a statewide quality alliance wherein CCNC provides the NC-HIE, Transitional Care resources, and Advanced Care Planning support necessary to encourage treatment in place and lower the 30-day readmit and inpatient survival trajectory of elderly Medicare and Medicaid patients.• Led team to develop platform technology solution to warehouse and distribute multiple discrete clinical and claims data sources for integration within analytics interface. Established data governance and aggregation standards to allow population health risk segmentation and attributed RAF profiles. • Developed market acceleration strategy for NC-HIE in coordination with a clinically integrated LTC network initiative.• P&L experience as in-house consultant for several small (10,000+ attributed lives) and large (80,000+ lives) partner ACO's. Extensive experience in chronic population health management including BH, LTC, and Palliative care in integrated, telehealth environments. -
Chief Operating OfficerRha Health Service, Inc Jul 2005 - Oct 2012Asheville, Us$220M multi-specialty health care system including 2 sub-acute 16-bed facilities, 15 outpatient clinics, 2 pharmacies, 12 licensed treatment programs, and 400+ clinical staff providing services to 25,000 patients annually across NC, TN, and GA.Recruited as founder of RHA's Behavioral Health and Integrated Care Division. Led business development efforts that set the stage for long-term partnerships with managed care and health system networks as the organization grew to a $220M integrated health care system through 9 acquisitions. • Founded Behavioral Health and Integrated Care Division—grew annual revenue from $0 to $40M in 6 years through 9 acquisitions and organic growth to include 2 sub-acute hospitals and 15 outpatient clinics. Over 70% of revenue was at-risk.• Built robust chronic disease management protocols and care management infrastructure leverage targeted “high-touch” care management, medication reconciliation, and innovative telemedicine access, saving $1.8M in medical staff costs each year.• Led expansion of health care services into Georgia Medicaid, securing initial $10M contract for Long Term Care. • Strategically positioned RHA into a dominant market position in 8 geographic areas aligned with regional health systems to maximize the intrinsic value of the company. Successfully negotiated and managed at-risk contracts and leveraged the attributed lives to recruit a regional clinically integrated network.• Coordinated, led RHA lobbyists in campaign that successfully preserved $800M in North Carolina funding for long term care despite the state's $2B fiscal deficit that year. -
ConsultantNc Department Of Health And Human Services Dec 2006 - Jul 2008Provided consultation to the Secretary of DHHS on strategic and operational policy and its potential impact on the health care industry. Designed and implemented executive dashboard tools to track clinical outcomes and expenditures in the NC Medicaid program managed by Community Care of NC.
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CeoLearning Perspectives, Inc Jun 2000 - Jul 2005Health care company operating 3 outpatient allied health clinics in Eastern NC with $5M turnover and 30 employees.Created vision and developed business plan and growth strategy for successful start-up health care company. • Grew company from $0 to $5M in annual revenue by providing school-based health clinics. Responsible for all infrastructure development including payer negotiations, claims adjudication, compliance, and credentialing. Implemented and customized practice management software to manage billing, HR, scheduling, and documentation to minimize compliance risk.• Founding member of NC Provider Council, industry trade and advocacy organization successful in influencing public policy to expand integrated care model. Led state rate setting committee.• Successfully positioned and negotiated the sale of the company at 15X the original investment.
Mike Rhoades Skills
Mike Rhoades Education Details
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UncwInternational Business -
Augustana College (Sd)Psychology
Frequently Asked Questions about Mike Rhoades
What company does Mike Rhoades work for?
Mike Rhoades works for Alera Health
What is Mike Rhoades's role at the current company?
Mike Rhoades's current role is CEO of Alera Health.
What is Mike Rhoades's email address?
Mike Rhoades's email address is mt****@****ail.com
What is Mike Rhoades's direct phone number?
Mike Rhoades's direct phone number is +191043*****
What schools did Mike Rhoades attend?
Mike Rhoades attended Uncw, Augustana College (Sd).
What are some of Mike Rhoades's interests?
Mike Rhoades has interest in Children, Flying, Snowboarding, Politics, Biking, Hiking, Science And Technology, Travel, Health.
What skills is Mike Rhoades known for?
Mike Rhoades has skills like Strategy, Strategic Planning, Leadership, Start Ups, Healthcare, Management, Entrepreneurship, Business Strategy, Business Development, Consulting, Program Management, New Business Development.
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