Tom Betlach joined Speire Healthcare Strategies in 2019 as a Partner to advise government and private sector clients on complex health policy and strategic initiatives. He is a nationally recognized thought leader on Medicaid and healthcare policy, known for his expertise in serving complex populations, delivery system transformation, value-based purchasing, managed care, and cost containment. Prior to joining Speire, Tom completed 27 years of state service in Arizona, working for five different Governors in three different cabinet positions.
For almost ten years, Tom served as Director of the Arizona Health Care Cost Containment System (AHCCCS), Arizona’s single state Medicaid agency, where he reported directly to the Governor. AHCCCS provided health care coverage to 1.9 million Arizonans at an annual cost of $13 billion.
During his tenure, Arizona was an early innovator in leveraging competitive managed care contracting strategies to transform the delivery system. Under Tom’s leadership, Arizona successfully pursued a multi-year strategy to integrate behavioral health services, expanded the delivery of services to address social determinants of health and pursued value-based purchasing strategies. He led Arizona in partnership with the federal government to create new tools for states to successfully integrate and improve services for those dually eligible for Medicaid and Medicare. Arizona remains one of the most cost-effective long-term care programs nationally and Arizona has maintained high levels of home and community-based placement for persons with long term care needs.
Tom was integral to Arizona’s development of a broad coalition to streamline justice system transitions to health care. This multi-pronged, collaborative strategy resulted in a more effective approach to deliver care for individuals transitioning from the justice system. The effort aligned well with broader initiatives in the Medicaid program to expand housing and employment support services. Upon his departure, Arizona Medicaid was the third largest housing authority in Arizona. He also led initiatives to develop stronger partnerships with tribal organizations. Through innovative 1115 waivers and other authorities, Arizona created first in the nation models to improve services for tribal members and reduce healthcare disparities. Tom was instrumental in advancing the Arizona Crisis System which has become a national model. Tom also served in a leadership role with Health Current, the Arizona Health Information Exchange, where he worked to create an expansive set of incentives encouraging provider and payer participation.
During the past six years with Speire, Tom has been engaged with 20 state Medicaid programs offering strategic support in several different areas. Examples of these projects have included supporting 10 different states with implementing strategies to improve delivery systems serving dual eligible members. Other work includes developing a series of strategic sustainability recommendations, behavioral health redesign, support for managed care procurements, developing new 1115 waivers to expand and broaden Medicaid coverage, and improved managed care oversight and leadership development support. Additionally, Tom was retained by the National Association of Medicaid Directors at the start of the pandemic and helped facilitate a bi-weekly call with all state Chief Financial Officers. In addition to his work with state clients, Tom supports a number of private sector organizations that serve the Medicaid population.
Tom served as both Vice President and President of the National Association of Medicaid Directors. He currently serves on the Board for the National Committee for Quality Assurance (NCQA), Circle the City, a Phoenix-based provider serving individuals facing homelessness, Mutual Insurance Company of Arizona, and Oakwood Creative Care, which serves people facing memory issues through creating programs that bring joy.
Tom holds a Master’s in Public Administration from the University of Arizona and a Bachelor of Arts in Political Science from the University of Wisconsin.