Why Medicaid Matters: Chestnut CEO Dr. Dave Sharar on Mental Health, Access, and Reform

On this episode of the Catalyst Podcast we speak with Chestnut Health Systems' CEO Dr. Dave Sharar. We discussed:  Dave’s 35-year career at Chestnut Health Systems, including his current role as CEO and his previous leadership of Chestnut Global Partners, where he managed behavioral health services for over 600 employers and 1 million employees worldwide. The significant shift in public and political attitudes toward mental health and substance use disorders over the past decade, with increased recognition and bipartisan support for expanding treatment resources. Medicaid’s role as the largest funder of mental health and substance use services in the United States, providing essential healthcare access for millions of Americans, including the working poor. Chestnut’s evolution into an integrated healthcare organization, now a federally qualified health center, combining behavioral health with primary care. The benefits of an integrated care model, where multidisciplinary teams coordinate to reduce inefficiencies and improve outcomes for patients with complex needs. The potential negative impact of Medicaid funding cuts, particularly on rural areas and small towns, where access to substance use disorder treatment is already limited. The success of Chestnut’s walk-in medication-assisted treatment program for opioid use.  Challenges associated with proposed Medicaid work requirements, including the failure of previous attempts and the likely overestimation of able-bodied, non-working Medicaid recipients. Dave's cautious optimism that policymakers will appreciate Medicaid’s importance and approach any reforms thoughtfully.