What does it take to build a healthcare model that actually works for youth in foster care?In this episode of Self Disclosed, I sit down with Cheryl Fisher, Vice President of Business Development (Foster Care and Child Welfare Programs) at Centene Corporatio, to unpack what she’s learned from decades of work in child welfare.From her earliest days as a trauma counselor to now overseeing one of the nation’s largest foster care health programs.We cover:✅ The emotional moment that got Cheryl hooked on this work✅ What most people misunderstand about why kids enter foster care✅ Why fewer kids are entering the system today and what’s behind the shift✅ How Centene’s “Centers of Excellence” are transforming care delivery✅ The hard truth about what happens when kids age out of the system✅ Why our current funding models make it hard to invest in real prevention✅ Cheryl’s bold vision for how states can design truly family-centered systemsCheryl Fisher brings rare depth, clarity, and compassion to this conversation and doesn’t shy away from the hard trade-offs.Whether you work in managed care, social services, or just care about building systems that don’t fail our most vulnerable youth, this episode is for you.🎧 Subscribe for more conversations like these#ChildWelfare #FosterCareReform #HealthcareInnovation #ManagedCare #SocialDeterminants

Youth behavioral health is in crisis, and the way we’re addressing it isn’t working. In this episode, Patrick Gilligan sits down with Leslie Courtney, Chief Commercial Officer and 25-year health care veteran, to unpack why teens are still falling through the cracks and what it will take to truly make a dent.We cover:

✅ Why treating teen mental health like adult mental health is a major mistake

✅ The hidden cost of ignoring resilience in youth

✅ How parents can embrace failure as a learning tool

✅ What health plans and states can do today to improve access and engagement

✅ How to design behavioral health solutions teens actually want to useLeslie brings stories from her work at Blue Cross, MDLIVE, Papa, and in teen mental health, plus her own experiences raising two kids, to shed light on what’s broken and how to build a future where young people thrive.

🎧 Subscribe for more conversations like these.

#TeenMentalHealth #HealthcareInnovation #ParentingTips #YouthWellbeing #BehavioralHealth

In this episode of Self Disclosed, we sit down with Ellie Robinson of Rhode Island’s Executive Office of Health and Human Services to break down how a small state is making a big impact on youth mental health.We cover:✅ What Rhode Island’s youth behavioral health system looked like in 2021 and what had to change✅ Why mobile crisis response became a cornerstone of their care model✅ How Ellie’s team used lived experience and qualitative data to shape real policy✅ The award-winning marketing campaign that helped families actually use the system✅ What it really takes to build a system of care that meets families where they areWhether you're building a statewide strategy or just want a front-row seat to what's working in community-based mental health, this episode is a masterclass in sustainable systems change.🎧 Subscribe for more conversations like these#YouthMentalHealth #SystemOfCare #BehavioralHealth #PublicHealthInnovation #FamilyEngagement

Why is healthcare in the U.S. so broken, and why does every attempt to fix it seem to fail?

In this episode of Self Disclosed, Patrick Gilligan sits down with Neil Carpenter, Health Care Innovator & Partner at North Gate Group, to unpack what really goes on inside hospitals, why value-based care still struggles, and what it's going to take to transform the system.

Neil shares hard-won insights about entrenched incentives, automation, virtual care, the myth of innovation in legacy institutions, and how we might actually rebuild the system to better serve everyone, especially the most vulnerable.

Whether you're a policymaker, health tech founder, or just someone trying to understand why it’s so hard to get a doctor’s appointment, this episode will change how you think about healthcare.

—⏱️ Timestamps

00:00 – Intro

01:00 – What people don’t see about life inside a hospital

03:30 – Why hospitals resist automation (and still use phones!)

06:00 – The call center experiment that slashed costs

08:00 – Hospitals as inefficient economic engines

10:00 – Virtual care and creating real competition

13:00 – Why value-based care hasn’t taken off

15:00 – The real reason surgeries are overused

18:30 – What happens when incentives are misaligned

21:00 – A personal story of growing up poor and relying on public infrastructure

23:00 – Why marginal surgeries may keep hospitals afloat

26:00 – The problem with short-term thinking in healthcare leadership

29:00 – We need to “Amazon-ify” the hospital

31:00 – Where AI and automation can (and should) replace humans

35:00 – Redefining what “critical infrastructure” in healthcare means

37:00 – The future: virtual-first, automated, prevention-focused

41:00 – Can robots replace surgeons?

44:00 – Why every conversation in healthcare costs society

46:00 – Neil’s personal mission: fixing the system because he had to

🎧 Subscribe for more conversations like these.

#healthcareinnovation #valuebasedcare #healthpolicy #automation #virtualcare #digitalhealth

Most health tech founders avoid Medicaid because of the red tape, slow sales cycles, and tough margins. But Nikita Singareddy is proving that it can be done with clarity, focus, and a deep respect for the system's complexity.

In this episode of Self Disclosed, Patrick sits down with Nikita, CEO of Fortuna Health, to unpack how her team is helping Medicaid plans retain members and stay compliant, without relying on fancy narratives or bloated promises.

From navigating the 834 data file to building products plans actually want, Nikita offers a masterclass in Medicaid venture building, grounded in policy, designed for real-world impact.

They also dive into upcoming federal changes that could reshape Medicaid eligibility and force plans to rethink engagement, compliance, and ROI.

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⏱️ Timestamps:

00:00 – Intro: Why Nikita is called the "Medicaid whisperer"

01:00 – What Fortuna gets right that others don’t

03:45 – The data problems nobody talks about

06:00 – What’s actually in the 834 file?

08:00 – Margin matters: different members, different dollars

10:30 – The startup mistake that kills healthcare products

12:30 – The MCO mindset: short-term ROI or bust

14:00 – How Fortuna earns trust with plans

16:00 – What internal champions really need

18:00 – The power of the demo

20:30 – The unsung heroes inside health plans

22:00 – Call centers, quality metrics, and clinical deserts

23:40 – Getting Medicaid members to actually engage

25:30 – What consumer tech gets right that healthcare doesn’t

28:00 – Why everything in healthcare is designed—and can be redesigned

30:00 – The Frankenstein system we’ve inherited

32:00 – What if we rebuilt Medicaid from scratch?

34:00 – Physician shortage as a national crisis

36:00 – AI can help, but it won’t replace humans

37:00 – Upcoming federal reforms MCOs need to prepare for

🎧 Subscribe for more conversations like these

#medicaidtech #healthcareinnovation #policytoimpact #digitalhealth #startupstrategy #healthplans #medicaidstartup

What happens if we don’t fix American healthcare?In this episode of Self Disclosed, Patrick Gilligan talks with Candace Richardson, Partner at General Catalyst and one of the leading voices in healthcare investing, about the looming macroeconomic, societal, and ethical consequences of a broken health system and why she still believes there’s time to turn it around.

Candace unpacks why the stakes have never been higher, why the future of care depends on tech-enabled services, and how AI is quietly transforming margins, workflows, and access.

She also shares hard-earned advice for founders building in Medicaid, outcomes-based care, and highly regulated markets, plus the legacy she hopes to leave behind.

We cover:

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⏱️ Timestamps

00:00 – Intro: The mental health funding boom

00:59 – The $4T problem no one is solving

02:00 – What a sick, aging society means for the economy

03:30 – Healthcare vs. education: a state budget death spiral

05:00 – Will Medicare even exist when we retire?

06:00 – Why Candace is still optimistic about U.S. healthcare

08:10 – Tech is finally catching up to healthcare’s complexity

10:30 – Why health tech is more expensive to build

12:00 – The dream of replacing legacy systems like Epic

13:50 – How AI is driving down build costs and boosting outcomes

15:00 – Advice for modernizing public health infrastructure

17:30 – The 90/10 Medicaid incentive that no one talks about

20:00 – What actually changed in healthcare VC post-2020

22:00 – Why every services business now needs AI-native DNA

24:30 – The capital gap after Series A and how to survive it

26:00 – “What if Oak Street had been built in 2025?”

28:00 – Why AI’s biggest wins won’t be an AI doctor

30:20 – The shift in product velocity thanks to AI

32:00 – Will legacy orgs get left behind in the AI wave?

34:00 – Founders need near-term ROI to win adoption

36:00 – The hard psychology of building in a slow industry

38:00 – Why real healthcare change requires long-term vision

40:30 – Candace on being wrong about AI—and why she changed

43:00 – The white papers influencing CMS policy

46:00 – The power of influence when you don’t own the outcome

49:00 – The legacy Candace wants to leave in healthcare

52:00 – Snap your fingers: one fix to change it all

—

🎧 Subscribe for more conversations like these

#healthcareinvesting #valuebasedcare #medicaidinnovation #healthtech #venturecapital #aiforhealthcare #theaugmentedlife #generalcatalyst #candacerichardson

What does it take to transform a state’s mental health system, starting from the ground up?

In this episode of Self Disclosed, Patrick Gilligan sits down with North Carolina Senator Jim Burgin, the man behind one of the most ambitious mental health investments in the country: an $835 million plan to address youth mental health, foster care, addiction, and systemic reform.

Sen. Burgin shares the personal and professional moments that shaped his mission to make North Carolina the healthiest state in America. From town hall listening tours to radical ideas like “safety trampolines” (not safety nets), he breaks down what real, sustainable change looks like and why it starts with dignity, early intervention, and community.

We cover:

• Medicaid expansion and mental health ROI

• Why kids need fewer phones and more imagination

• How to rethink foster care from the ground up

• What we can learn from death row inmates

• The trap of lifelong government programs

• Why culture, not just policy, drives health outcomes

This is a conversation about hope, responsibility, and the long game of public service.

—

⏱️ Timestamps

00:00 – Why everyone says they want better outcomes, but incentives are broken

01:45 – Misaligned incentives in Medicaid and managed care

03:30 – What makes North Carolina different from other states

06:00 – Delayed reimbursements and the reality for small providers

07:25 – The personal loss that shaped Senator Burgin’s mental health mission

10:30 – Why bipartisan support for mental health is possible (and necessary)

12:00 – The power of listening: 14 town halls across the state

14:45 – The rise of youth hopelessness and phone addiction

17:00 – “Safety trampoline” vs. “safety net”: a new mental health philosophy

20:30 – Foster care reform and putting the whole family in care

25:00 – Why Medicaid should launch people, not trap them

30:00 – The danger of identity attachment in recovery

32:00 – The balance between individual responsibility and systemic support

34:00 – Education, community colleges, and a culture of ambition

38:00 – Faith, mentorship, and bringing churches back into the conversation

41:00 – What success looks like in 10 years: no involuntary commitments

44:00 – Influencers, body image, and protecting kids online

48:30 – Advice for other state leaders: go visit, go listen

50:30 – How curiosity drives real change in policy

🎧 Subscribe for more conversations like these

#mentalhealth #publicpolicy #fostercare #medicaid #healthcareinnovation #youthmentalhealth #beyondthecore

In this episode of Self Disclosed, Patrick sits down with Sean Schreiber, Chief Operating Officer of Alliance Health to explain how Alliance is building a care system that’s faster, more community-centered, and deeply personal.

Sean shares his unlikely journey from outpatient therapist to statewide innovator, and outlines the playbook Alliance uses to test, scale, and fund new mental health models. You’ll hear candid reflections on youth behavioral health, Medicaid innovation, system design, and why solving for “just 24 people” is sometimes exactly the right starting point.

We cover:

—

⏱️ Timestamps

00:00 – Life updates, remote work culture & family stories

03:10 – Why people struggle with isolation in remote roles

04:45 – What makes Alliance Health a national model

06:00 – The North Carolina Medicaid structure that enables innovation

07:00 – Why community-rooted orgs move faster than corporates

08:10 – Sean’s origin story: from psychology major to COO

12:00 – The problem with traditional outpatient mental health

14:45 – Early efforts to expand access and reinvent programs

16:00 – What’s improved (and what hasn’t) in the care system

17:20 – How Alliance prioritizes which problems to solve

19:00 – The internal pressure of knowing people are waiting for help

20:30 – How Alliance funds innovation without chasing ROI

22:00 – The playbook for testing new care models safely

24:00 – Why not everything needs to scale to matter

26:00 – The reality of measuring success in complex populations

29:00 – The state’s billion-dollar bet on behavioral health

31:00 – Why youth are underserved in the commercial system

33:00 – How COVID & social media transformed youth anxiety

34:30 – Foster care challenges and systemic failures

36:00 – Sean’s 10-year vision: simple, stigma-free access for all

38:00 – What excites Sean about tech, AI & the future of care

40:00 – Advice for health plan leaders who want to move faster

42:00 – Why serving just 30 people can be the right starting point

44:00 – Sean’s personal legacy and what still drives him

—

🎧 Subscribe for more conversations like these

#mentalhealth #medicaidinnovation #youthbehavioralhealth #fostercare #healthplans #alliancehealth #beyondthecore

What does it take to rebuild an entire state’s mental health system while staying grounded in lived experience, clinical insight, and community trust?In this episode, Patrick Gilligan sits down with Kelly Crosbie, Director of North Carolina’s Division of Mental Health, Developmental Disabilities, and Substance Use Services. Kelly shares how she’s helping lead an unprecedented $835M investment to reimagine the state's care continuum from crisis response to upstream prevention for youth and families.Drawing on her experience as a clinician and parent, Kelly talks candidly about building a system that’s not just clinically effective but deeply human. They cover bold goals like eliminating institutional placements for youth, funding mental health like core infrastructure, and centering lived experience at every level of leadership.We cover:⏱️ Timestamps00:00 – The first time Patrick met Kelly and what stood out01:36 – The reality of receiving $835M for mental health03:25 – The Secretary’s bold vision and the system's biggest pain points05:01 – How Kelly created a statewide strategic plan06:15 – Community input and what the data couldn’t show07:30 – Crisis response: Why the ER is failing vulnerable populations09:15 – The statewide vision in one sentence10:44 – Mental health care access and quality for all11:39 – Why NC is taking action now and how it got bipartisan support13:28 – Leading with authenticity and lived experience16:12 – From clinician to state leader: How front-line work shapes policy22:14 – Person-centered care vs. bureaucratic red tape24:03 – Why NC lets non-licensed staff deliver care and what that means25:00 – The deep end of the ocean: NC’s most complex youth cases27:24 – Access and prevention: Reaching kids early through schools and tech29:35 – The role of families in youth mental health30:56 – Is a future without out-of-home placement possible?33:22 – Looking nationally: Who inspires Kelly and what NC is borrowing36:52 – Advice to new mental health leaders in other states38:40 – Building trust with legislators and partners across interest lines41:05 – Rethinking crisis response and the sheriff’s role42:37 – What long-term, sustainable funding looks like45:22 – Streamlining priorities: From “a thousand daisies” to focus49:06 – How parenting changed Kelly’s leadership lens51:03 – Social worker of the year: What the award meant🎧 Subscribe for more conversations like these#mentalhealth #publichealthleadership #healthinnovation #ncmentalhealth #kellycrosbie #beyondthecore #childmentalhealth #healthsystems #behavioralhealth #socialwork