Rachel speaks with Nicole Sartini, a licensed clinician, group practice owner, and founder of Build Better Health — a nonprofit think tank that is building the kind of collective provider power that this field has been missing.
Nicole came to advocacy the way most providers do: through her own practice. In 2024, after ten years of building Bridge Counseling and Wellness into a 60-provider group practice in Louisville, Kentucky, she watched insurance carve-outs and contract repairing cut her practice's income by 30 percent for the same number of sessions. She started organizing locally — monthly meetings, surveys, conversations with the Kentucky Department of Insurance — and discovered something that stopped her in her tracks: the laws protecting providers from exactly this kind of harm already existed. They just had no teeth to enforce them.
What started as a small Kentucky organizing effort has grown into a 50-state coalition with 4,000 providers directly participating. The Mental Health Insurance Reform Task Force is now structured around state-specific pages, state leads, and three national committees — Education, Innovation, and Legal and Legislative — with a team of attorneys tracking litigation opportunities and model legislation based on successful wins in states like Illinois, where HB1085 connected the reimbursement floor to the Medicare rate and raised commercial insurance rates for providers by approximately 30 percent.
The conversation covers the two pillars of the Task Force's work: enforcing parity law, and protecting provider independence as insurers and behavioral health platforms consolidate. Nicole walks Rachel through what vertical consolidation actually looks like on the ground — providers being required to credential through third-party platforms to access major insurers, charts being pulled when providers leave, and data concerns that have no adequate legal framework yet. She also shares the Progressive Advocacy Ladder, a step-by-step framework that tells providers and state leads exactly where their state stands and what the next achievable step looks like. And she closes with an invitation: the Task Force meets the second Wednesday of every month at 11am Eastern — and everyone is welcome.
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