Health plan transitions happen — here’s how we protect your rates and clients

That said, sometimes plan structures or leadership change, and that can affect the terms of a contract. 

We sat down with Mike Maher, our Solutions Director, to learn how his team advocates for providers and clients when things shift behind the scenes. “Last year, a smaller regional plan that had historically relied on Optum for behavioral health decided to manage their own benefits, which meant that Headway would no longer be in-network, and we needed to secure a new contract quickly,” Mike explained.

For providers like you and your clients, transitions like this shouldn’t be a source of concern. Mike’s team stepped in to make sure they wouldn’t be: “That’s what we’re here for.”

“We’d been reaching out to the health plan’s team for weeks without response. But we saw that the plan was hosting a live Q&A session for their provider community. We joined the call so we could connect with someone live, which made it possible for us to secure a contract right before the deadline.”

Even with a new contract on the table, the team had to plan for every possibility.

“When next steps are out of our control, we need to have a backup plan,” Mike explained. “While waiting to hear back, we worked on a continuity of care plan so that sessions could continue while we chased down a plan representative.” 

The result? A smooth transition to a new contract — with no lapse in coverage, and providers’ rates fully honored. And just as importantly, it laid the groundwork for a stronger relationship with the health plan’s leadership team moving forward: “The conversations we had to get to this point helped us build a strong foundation with the plan’s leadership team so that we can continue to showcase Headway’s good work.”

Working with health plans is not always predictable — the weeks of back and forth in this example are not uncommon. But at Headway, we’re always working to anticipate challenges, minimize disruption, and protect the people we serve.

We’re proud to have experts like Mike’s team advocating for our network — so you can spend less time navigating red tape and more time supporting the people who count on you. Because, at the end of the day, we believe that making mental healthcare more accessible starts by showing up for the people who give it and those who need it most.