When asked how they navigate policy swings, reimbursement challenges and rapid innovation, behavioral health leaders voiced a common thread: stay anchored to mission, protect access and build systems resilient enough to withstand change.
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Editor’s note: Responses have been lightly edited for clarity and length.
Question: In today’s environment of policy volatility, reimbursement pressure and rapid innovation, how do you navigate enterprise-level decision-making when conditions are constantly shifting — and what serves as your system’s/organization’s North Star?
Mission as the anchor
Quatiba Davis. Chief Clinical Officer of ABA Centers (Fort Lauderdale, Fla.): I continue to be innovative when I see that change will strengthen or better support clinical care within the applied behavior analysis field. Conditions are constantly evolving, so my approach is to remain responsive while keeping the needs of individuals and families at the center of every decision. I rely on data-informed decision-making, strong clinical ethics and collaborative leadership to make thoughtful choices, even when information is incomplete. Rather than simply reacting to change, I look for opportunities to improve access, quality and sustainability by aligning clinical excellence with operational realities. Our organization’s North star is delivering meaningful, life-changing outcomes through accessible, high-quality care. Every operational, financial and clinical decision is guided by one question: Does this improve care and long-term impact for the families we serve? When that purpose leads, innovation becomes intentional and change becomes an opportunity to advance the field of applied behavior analysis and individuals living with autism.
Dominique Dietz. Director of Virtual Behavioral Health at OSF HealthCare (Peoria, Ill.): We navigate enterprise-level decision-making in a rapidly changing environment by remaining anchored to our unwavering mission to serve with the greatest care and love. As a Catholic healthcare organization, we are mission first. Every strategic decision begins with a simple but essential question: How does this help us serve with the greatest care and love? Whether evaluating new care models, addressing reimbursement challenges or adopting innovative approaches, we ground our decisions in respect for the dignity of every person and the well-being of the communities we serve.
In practice, this means prioritizing equitable access to care, especially for vulnerable populations; keeping people at the center by measuring success through meaningful patient outcomes and experiences, not solely financial performance; engaging interdisciplinary leaders, physicians, mission partners, and community voices; communicating transparently and acting with ethical stewardship; supporting and investing in our mission partners; and exercising disciplined stewardship of resources to ensure long-term sustainability.
Leadership in uncertain times requires both courage and humility. By consistently filtering decisions through our mission, vision, and values, we can move forward with clarity and confidence knowing that our North Star is not a financial metric, but our sacred calling to serve.
John Driscoll. President and CEO of Caron Treatment Center (Wernersville, Pa.): In a world of policy volatility, reimbursement pressure and rapid innovation, we anchor decisions to a clear north star: our mission to transform lives impacted by addiction and co-occurring mental health disorders. We pair that mission with agility — proactively looking for better, more accessible ways to deliver evidence-informed care and create efficiencies without compromising quality. We don’t fight the waves of change; we learn to surf them using data, staying close to what patients and families need — and adjust our continuum of care as the science and healthcare landscape evolve.
Tracey Izzard. Vice President of Behavioral Health at Sentara Health (Norfolk, Va.): At Sentara, our North Star is our mission to improve health every day. This is a principle that unifies our strategy across care delivery, health plan and community impact. This mission is operationalized through commitments to safety, dignity, responsiveness and involvement for every patient and member. It also extends beyond clinical walls into proactive community engagement and health equity investments. Some of our examples include community benefit funding, mobile care expansion, workforce pipeline programs, and programs that address social drivers of health or strengthen resilience in the populations we serve. Our mission sharpens decision-making in three practical ways:
- It anchors us in whole-person health.
- It aligns short-term financial stewardship with long-term value.
- It disciplines our innovation.
In a constantly shifting environment, strategy must remain adaptive, but purpose must remain fixed. When our daily decisions regarding capital allocation or clinical pathway design are consistently filtered through the commitment to improve health, volatility becomes manageable. The mission becomes the stabilizer, ensuring that growth, transformation and operational change all point in the same direction: measurable improvement in the health of the communities we serve.
Dorinda Mueller, MSN, RN. CEO of Aliso Ridge Behavioral Health (Lake Forest, Calif.): In today’s environment of constant healthcare evolution, one stable resource is the purpose behind our organizations — the patient. If the patient is placed centrally with all decisions in some aspect, the journey to get there is worth the struggles. Ultimately, one successful approach to supporting change is to involve the frontline staff. You would be surprised how many staff want to participate in initiatives where their voice matters. They will take ownership of rewriting policies, developing education, collecting data and serving as a change agent. I have been blown away by the staff that has stepped up to support initiatives time and time again.
With that being said, there is still a lot of investment in the frontline-driven approach. It is imperative to attend meetings, promote ideas that are within reason and encourage staff curiosity in exploring alternatives and options. The reward is worth the time commitment tenfold as staff feel rejuvenated, appreciated and involved beyond a paycheck. Simply put, if the patients we serve are constantly the North Star, the ups and downs will remain but the focus is clear.
Access and integration as strategy
Matthew White, MD. Chair of the Behavioral Health Service Line at Sutter Health (Sacramento, Calif.): At Sutter Health, our guiding principles remain patient-centered and anchored in our values of compassion, excellence and teamwork, even as conditions evolve. Rising demand reinforces the importance of simplifying pathways to care and continuing to expand crisis, outpatient and virtual services. At the same time, we are integrating behavioral health into primary care so that patients receive support earlier.
We guide enterprise decisions through access, integration and clinical excellence. We are investing in collaborative care models, workforce growth, strategic partnerships and strengthened care navigation to improve outcomes and reduce fragmentation. Every innovation is evaluated through a simple lens: Does it help patients get the right care at the right time? If it does, it aligns with our strategy.
Teresa Lopez. Director of Behavioral Health Integration at University of Utah Health (Salt Lake City):
- In a volatile policy and reimbursement environment, we anchor decisions in a clear north star: improving access and outcomes for patients with the greatest complexity through integrated, sustainable care models.
- Because programs and funding change, we prioritize strategies that address enduring needs — like integrated behavioral health in primary care — and that can flex across payment structures. One example is utilizing the collaborative care model to fidelity.
- Data and outcomes, frontline input, and sustainability must guide our decision making in all our operations.
LalithKumar Solai, MD. Vice Chair of Clinical Services in the Department of Psychiatry and Behavioral Sciences at MUSC Health (Charleston, S.C.): There are no easy solutions to this, but the system leadership’s commitment to serve the patients by improving access is our North Star. We realize policies will change, reimbursements go (mostly) down and innovations will disrupt, but the focus on strategizing and adapting to the changing environment is constant. We believe in strong public, private partnerships to help us follow the North Star.
Enterprise resilience and system sustainability
Carl Hoopes. Executive Vice President and COO of GRAND Mental Health (Claremore, Okla.): In an environment defined by policy volatility, reimbursement pressure and rapid innovation, enterprise decision-making has to be anchored in purpose rather than reaction. We start by staying grounded in our mission and the populations we serve, then assess decisions through the dual lens of long-term sustainability and access to care. That requires financial discipline, operational agility, and a relentless focus on frontline insight so strategy reflects real-world impact. Our North Star is delivering high-quality, patient-centered behavioral health care at scale. When leaders remain aligned to that purpose, they can navigate uncertainty with confidence and make decisions that hold up regardless of regulatory or market shifts.
Jesse Tamplen. Vice President of Care Coordination and Continuous Performance Improvement and Executive Administrator of Behavioral Health at John Muir Health (Walnut Creek, Calif.): Healthcare systems operate as complex enterprises where decisions rarely remain confined to a single department or service line. Capacity strategies influence patient flow. Workforce models reshape safety dynamics. Financial initiatives alter clinical operations. What may appear to be a localized (siloed) department adjustment often produces enterprise-wide consequences. Effective leadership requires moving beyond linear decision frameworks and applying systems thinking as a foundational leadership principle.
The external environment further intensifies this challenge. Regulatory bodies, policymakers, advocacy organizations, and the media increasingly shape health care strategy, particularly in high-profile areas such as behavioral health. A leader’s decisions are evaluated not only through operational and financial lenses, but also through social, political and community trust contexts.
For behavioral health leaders, these pressures are even more pronounced. Clinical capacity, reimbursement structures, regulatory frameworks, workforce sustainability, and community trust are deeply interconnected. Decisions affecting behavioral health services carry amplified implications, influencing emergency department patient throughput, inpatient capacity, safety outcomes, and timely access to life-saving care. The stakes are both operational and profoundly human.
Behavioral health cannot function as an isolated service line. It is a critical component of whole-person care, influencing outcomes across emergency, medical, and ambulatory care sites. Enterprise decisions must therefore reflect system realities rather than solely departmental optimization.
Critical is clarity of purpose. At John Muir Health, our true north goals, which include employee engagement, safety and quality, financial stewardship and patient experience, serve as essential anchors in navigating uncertainty. These priorities provide decision-making stability while allowing strategies to evolve, reinforcing the need for adaptability to remain aligned with workforce well-being, patient safety, care quality and long-term sustainability of our not-for-profit healthcare system.
Key takeaway: Health care leaders operate where financial pressure, regulatory complexity and human vulnerability intersect. In this landscape, systems thinking is not a leadership advantage; it is a survival skill to achieve true north goals.
Dawn Zieger. Vice President of Psychiatry and Behavioral Health and Assistant Professor at Geisinger (Danville, Pa.): Given the pace of change in our field — and the very real threats to long‑standing programs — having a strong, intentional contingency strategy is essential for sustaining services. Within our organization, we are proactively building more braided funding structures that combine fee‑for‑service reimbursement with foundation support and grant funding. This diversification strengthens the stability of our programs and reduces our vulnerability to any single funding source.
Recent events have underscored why this approach is necessary. When SAMHSA announced the discontinuation of 2,800 behavioral health grants with only one day’s notice — only to reinstate them the following day — many providers were left shaken and uncertain about the reliability of federal grant streams. That instability was compounded by ongoing regulatory shifts affecting virtual care, which remains a critical strategy for expanding capacity in rural areas where workforce shortages are most acute.
The reality is that we must be prepared for rapid, unexpected changes. This moment calls for steady, resilient leadership that can navigate volatility while keeping services intact. Our patients rely on us, and they need us to stay focused, nimble, and unwavering in our commitment to access and continuity of care.
