In this week’s issue: new telehealth legislation, Medicaid disability reform, rural behavioral health strategies, Michigan redesign news, SUD and legislative updates, major philanthropic investments, and new resources and RFPs shaping the behavioral health landscape. Pull Up Your Chair & Let’s Start the Conversation.

The Redesign

How providers can preempt PIHP/CMHSPs attempts to pit them against each other

As Michigan prepares for a new behavioral health system, a lot of uncertainty remains. And in moments like this, even without any overt action, the environment is ripe for managed care organization to turn providers against each other through selective rates, quiet contract terms, or messaging designed to create doubt and division.

To be clear, we are not saying PIHPs are already doing this. But the risk increases during transitions, especially when payors are preparing for procurement, redefining roles, or building their internal capabilities. Many of these same risks also apply to CMHSPs, particularly when they function as both funders and direct providers. Providers can unintentionally become leverage points in someone else’s strategy if they are not prepared.

And once trust erodes, the provider voice fractures. Here is how to think about this strategically, not reactively. Michigan’s PIHPs could use rate-setting as a wedge. It is a classic fragmentation tactic. If providers start competing with each other on rates, PIHPs gain leverage and the provider network loses its strength. The same dynamic can occur when CMHSPs set rates or shift authorizations in ways that advantage their own programs. The only way to counter this is to eliminate the information asymmetry payors rely on, establish shared standards across the network, and increase transparency so PIHP and CMHSP behavior is visible to MDHHS.

Below is a practical strategy to prevent division before it starts.

Build a Shared Provider Baseline for Rates. Create a common understanding of actual cost of care, staffing assumptions, administrative burden, rate history and variance, and what constitutes a sustainable rate. A Provider Rate Compact can formalize this, a non-binding alignment on principles, not prices. Providers are not coordinating future rates or negotiating collectively. They are sharing information, which is permitted under antitrust law, to ensure transparency and prevent payors from exploiting information gaps. When everyone operates from the same factual baseline, no PIHP or CMHSP can quietly tell one provider, “We pay you fairly, it is the others who cost too much,” because the network is aligned around shared standards rather than competing on incomplete information.

Normalize Transparent Communication. Fragmentation happens in silence. Providers need structured ways to compare notes without violating antitrust rules, monthly debriefs, an anonymous reporting channel, and a shared log of concerning patterns including delayed payments, rate inconsistencies, steering, and non-renewals. This applies to both PIHPs and CMHSPs.

Preempt Rate Manipulation with a Unified Message. Every provider should align on a simple narrative that providers compete on quality, and that a strong network requires stability, transparency, and fairness. This message should appear in meetings, public comment, MDHHS communications, legislative briefings, and media. When providers speak from the same framework, it becomes harder for PIHPs or CMHSPs to divide them.

Shift All Rate Conversations Back to Access and Network Adequacy. Under the PIHP contract, payors cannot degrade the network to save money. They must maintain sufficient providers, minimize administrative burden, avoid service disruption, and justify cost variances with data. CMHSPs, acting as the local purchasing arm of the PIHP, are held to the same access and adequacy standards. If a PIHP or CMHSP attempts to reduce rates or shift contracts in ways that weaken the network, providers should frame it as, “This action undermines network adequacy and creates service risk.” That reframes the issue as compliance, not negotiation.

Establish a Provider Bill of Rights. This is not a legal document. It is a shared framework of expectations including transparent negotiations, predictable contract renewals, access to rate justification data, non-retaliation, and uniform treatment across providers by both PIHPs and CMHSPs. When expectations are shared, deviations stand out and providers can respond collectively.

Use MDHHS as the Backstop, Not the First Step. Examples of manipulation or retaliation should be documented and shared with the MDHHS and legislators. Frame it neutrally as tracking patterns that could affect system stability during the transition. Remember that PIHPs are ultimately accountable to MDHHS for the contracting behavior and actions of CMHSPs within their region.

Reinforce Trust Among Providers. Trust collapses when providers see each other as competitors. Build routine trust-building mechanisms including cross-provider working groups, shared advocacy briefings, transparent communication, and shared tools or training.

Call Out Fragmentation Tactics Early. When providers see rate differentials, selective recruitment, pressured concessions, steering, or unexplained non-renewals, they should respond with, “We want to ensure this remains a stable, conflict-free, provider-driven network. Can you walk us through the data used for this decision?” These tactics can come from PIHPs or CMHSPs, especially where CMHSPs are both payors and providers.

This is a year of transition. With transition comes pressure. But fragmentation is not inevitable. Providers who stay connected, aligned, and transparent will be far better positioned to avoid being pulled into someone else’s strategy, and far more prepared for whatever the redesigned system brings.

More on The Redesign

Local networks, real results: Success stories from Michigan’sCMHs – Rapid Growth, Rapid Growth

Dingell, Bergman Reintroduce Bipartisan Legislation to Permanently Extend Telehealth Flexibilities

Representatives Debbie Dingell and Jack Bergman have reintroduced bipartisan legislation to make permanent the telehealth flexibilities first adopted during the COVID-19 pandemic, ensuring continued access to remote care for millions of Americans. The Advancing Access to Telehealth Act recognizes what the public health emergency made clear: virtual care removes significant barriers for seniors, people with disabilities, and residents of rural communities who often face long travel times to see a provider. The bill would allow rural health clinics and federally qualified health centers to continue serving as distant sites for telehealth visits, permit a patient’s home to qualify as an originating site for all services, and authorize audiologists, physical therapists, occupational therapists, and speech-language pathologists to deliver care remotely. Dingell and Bergman say the goal is simple—protect a lifeline that has proven effective, efficient, and essential. See Bill Text here.

Improving Medicaid for People With Disabilities

Medicaid covers 15 million people with disabilities, but many still face barriers to care. The Center for Health Care Strategies explores how states can improve healthcare for people with disabilities by reducing red tape, supporting disability-competent care, and promoting more integrated approaches for funding and cost efficiency.

How the Rural Health Transformation Program Can Support Behavioral Health

About one in five people living in rural areas has a mental illness, but access to care is limited. The National Governors Association analyzes how states can use the Rural Health Transformation Program to grow the behavioral health workforce and improve access.

Legislative Updates

Celebrations

Michigan Business Beat | Linda Little, NSO – 70 Years of Service & the “Don’t Touch Me” Campaign - Michigan Business Network

The Ballmer Group is donating $72 million in behavioral health care projects in Illinois, Kansas and Michigan…

State grant funds first-of-its-kind Trauma Recovery Center in Grand Rapids' Heartside District, Newsbreak

Insight to host ribbon cutting for new psychiatric hospital Dec. 2

Aspirus Iron River adds clinical psychologist to behavioral health team

County resources available for those struggling with mental illness around holidays, Ottawa News Network

RFP 37-25-086 Fiduciary Partner for Community-Driven Health Funding Opportunities, including RFP docs, included in listing. Noting that all submissions must occur through BidNet Direct. Open Bids & Requests - Wayne County, Michigan