Meggan Bushee of Crossroads Treatment Centers on Leadership & Substance Use Treatment 10-5-25

Summary

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Becker Business Podcast: Meggan Bushee of Crossroads Treatment Centers on Leadership & Substance Use Treatment

Episode Date: October 5, 2025

Host: Scott Becker
Guest: Meggan Bushee (General Counsel & Chief Compliance Officer, Crossroads Treatment Centers)
Location: Live from the McGuire Woods Charlotte Growth and Operations Conference

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Overview

In this episode, Scott Becker sits down with Meggan Bushee, a legal and business leader, to discuss her journey from law school valedictorian to general counsel at Crossroads Treatment Centers. The conversation dives into trends and challenges within substance use treatment, especially for Medicaid populations, the evolution of value-based care, and Meggan’s philosophy of patient-focused leadership. The discussion also touches on the opioid epidemic, innovations in access to care, and advice for emerging leaders.

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Key Discussion Points & Insights

Introduction and Career Journey

• [00:00–01:30]
  Meggan introduces herself, including her education and career milestones—starting at McGuire Woods, serving in compliance at an ASC company in Texas, and currently at Crossroads Treatment Centers, a leader in behavioral health and substance use disorder (SUD) care.
  • Crossroads treats about 25,000 individuals daily, across nine states, focusing on heavily impacted and largely Medicaid-served populations.

Academic Motivation and Achievements

• [01:31–02:57]
  Meggan discusses her academic drive, graduating valedictorian from Wake Forest Law, and attending college on a full scholarship.
  • “I think you work harder when you're paying for it as you go and you're aware of the debt you will come out with.” (B, 01:55)
  • The experience opened opportunities at top law firms and set the tone for her career.

Trends and Challenges in Substance Use Disorder Treatment and Reimbursement

• [02:57–05:46]
  Scott solicits Meggan’s perspective on the SUD landscape and reimbursement dynamics:
  • SUD as a rapidly evolving field, only recently covered with dedicated payer reimbursement codes.
  • High cost to payers; 85% of Crossroads’ patients are on Medicaid, and 75% interact solely with SUD providers.
  • Value-based care contracts are emerging, helping to align provider and payer interests.
  • Imminent Medicaid program cuts and federal legislation will significantly affect the landscape by 2028.
  • “It's unique for the payers because this is their highest cost patient population... they're also a costly patient population to take care of.” (B, 03:41)

Addressing Social Determinants and Integrated Care

• [05:46–07:20]
  Meggan underscores that treating addiction alone isn’t enough—the vast majority of patients face mental health challenges and social determinants such as housing and food insecurity.
  • Crossroads advocates for the involvement of community health workers and peers with lived experience on care teams.
  • “If you can't help them settle those issues, they don't really have the time to focus on their healthcare needs.” (B, 06:22)

Innovation in Care Delivery: Mobile Clinics and Rural Access

• [08:01–09:16]
  Expansion plans at Crossroads include mobile and virtual healthcare to extend reach, especially in rural areas:
  • Launching a mobile methadone clinic in North Carolina, enabled by progressive payer partnerships and state licensure.
  • “One great example... we're going to launch our first ever mobile methadone clinic... it will have three stops a day.” (B, 08:01)
  • Innovative responses to geographic and logistical barriers, catalyzed by disaster relief grants and the unique needs of mountainous regions.

The Evolving Opioid Crisis

• [09:16–10:44]
  Discussion about the ongoing opioid epidemic:
  • Prevalence remains high; deaths related to opioids may have stabilized or declined due to factors like Narcan availability, but addiction rates continue to rise.
  • “It's impacting more and more people every year, not less. And the drugs that are driving the addiction are evolving.” (B, 09:35)
  • Increased survival from overdoses shifts the focus to long-term patient management.

Insights from a Diverse Healthcare Career

• [10:44–12:10]
  Meggan reflects on her experience across healthcare sectors:
  • Patient populations and their needs are highly variable across states and care settings, even within the same specialty.
  • At Crossroads, patient outcomes—not just operations—drive success.
  • “If we do right by them, we'll be successful as a company.” (B, 11:52)

Patient Spectrum and Behavioral Health Realities

• [12:10–13:11]
  Not all patients come voluntarily; many are referred or mandated by the criminal justice system or family members.
  • “Some of the patients are there involuntarily... that's how they avoided a sentence.” (B, 12:53)

Leadership Advice and Professional Fulfillment

• [13:11–14:14]
  Advice for emerging leaders:
  • Find passion in your work—skills will follow if you love what you do.
  • “As long as you wake up every day and have a passion and want to be there. I think people feel that, that you lead then.” (B, 14:04)

Perspective on Family and Career for the Next Generation

• [14:14–15:52]
  Meggan shares how her experiences have influenced her parenting approach:
  • Let children develop their own passions, rather than enforcing narrow expectations.
  • “If they, like, want to wake up and, like, go be an art teacher, I'm like, great, let's take our class.” (B, 15:09)

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Notable Quotes & Memorable Moments

• On treating substance use disorder holistically:
  “You can't just treat the addiction. Most of our patients also have some form of mental health that you have to address as well... If you can't help them settle those issues, they don't really have the time to focus on their healthcare needs.” (B, 06:15–06:22)

• On the impact of social determinants:
  “If someone is struggling with SUD, but you’re not helping them find housing, stable job, food sources, it’s just not going to be a priority.” (B, 07:06)

• On the value of passion in leadership:
  “As long as you wake up every day and have a passion and want to be there, I think people feel that, that you lead then. They know you enjoy your job. It helps them enjoy their job every day as well.” (B, 14:04)

• On the opioid epidemic’s evolution:
  “The drugs that are driving the addiction are evolving. We're having all of these kind of man made substances hit the streets and it's hard for the medicine to keep pace with the evolution of the drug market.” (B, 09:35)

• On healthcare business lessons:
  “No healthcare areas alike... Every patient population is different. Even if you're a multistate healthcare operator, you could be within the same specialty, but your patient populations, their needs and how to access them are going to vary by state.” (B, 11:14)

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Timestamps for Key Segments

• 00:35 – Meggan’s career intro and Crossroads’ mission
• 01:55 – Academic journey and drive
• 03:41 – Payer landscape and challenges in SUD treatment
• 06:15 – Integrating care for mental health and social needs
• 08:01 – Expansion into mobile methadone clinics
• 09:35 – State of the opioid epidemic and drug evolution
• 11:14 – Diverse healthcare lessons and patient focus
• 13:28 – Leadership advice: follow your passion
• 15:09 – Parenting, expectations, and letting kids follow their passions

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Tone and Style

The conversation is candid, practical, and centered on empathy, with Meggan Busshee demonstrating humility and a deep commitment to patient-centered care. Both speakers strike a balance between business pragmatism and heartfelt advocacy for vulnerable populations.

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Summary

This episode offers deep insights into leading behavioral health organizations and advancing substance use treatment in America’s most vulnerable communities. Bushee’s approach is holistic—addressing addiction, co-occurring mental health needs, and social determinants—in an ever-evolving regulatory and reimbursement landscape. Her emphasis on passion-driven leadership, innovation in care delivery, and the importance of acknowledging each patient’s unique journey is both inspiring and instructive for healthcare operators, leaders, and aspiring professionals.

Transcript

[A]

This is Scott Becker with a special combined episode of the Becker Private Equity Podcast and the Becker's Healthcare Podcast. I am thrilled today to be joined by Megan Bushy. And Megan is by background, one of the smartest people I ever had the chance to work with and she worked with me closely earlier in her career. Now she's going on to be general counsel of several companies and just a brilliant business and legal leader. We're recording today live from the McGuire Woods Charlotte growth and Operations Conference. Megan, can you take a moment to introduce yourself and tell us about what you do?

[B]

Yeah. Megan Bushy, I've been serving as general counsel and chief compliance officer for Crossroads Treatment Centers for the past six years. Prior to that, had another stint at an ASC company based out of Texas as their general counsel and chief compliance officer. And then the first stop on my career journey as Scott referenced, was about six and a half years at McGuire woods and their phenomenal healthcare group. But yeah, currently at what has probably been one of the more meaningful stops in my career journey, behavioral healthcare Crossroads Treatment centers every morning cares for about 25,000 individuals that are struggling with substance use disorder across nine states. Just been really impactful work working with a primarily Medicaid patient population and some really hard hit communities in this country.

[A]

So it must be amazing. I'm going to, I'm going to take people back for one second because if I remember, Megan is brilliant and also I think either was valedictorian for law school class or college class and also went on scholarship. Talk a bit about that drive and energy to be valedictorian and to go on scholarship to school. Just give us a little background as to what, what, what leads to that because that's an incredible feat.

[B]

Yeah. You know, I was lucky enough to go on full scholarship for state school. Stayed in state from Arizona, University of Arizona. Then wanted to go on and do graduate school and landed with law school. Really liked the law school program at Wake Forest University In Winston Salem, N.C. was able to get part of that funded by scholarship, but not all of it. And law school is expensive. If anyone's done any form of graduate program, I think you work harder when you're paying for it as you go and you're aware of the debt you will come out with. So yeah, worked really hard while I was in law school. I a little bit have a competitive nature in me anyway. And you know, when you're on a bell curve system, you know, you just, that brings that out in you. So, yeah, graduated valedictorian first in my class at a wonderful law school. And that opened up a lot of doors and gave me opportunities to work with really great law firms like McGuire Woods. And that's how I ended up in Charlotte, North Carolina with that firm.

[A]

I mean, it's really a remarkable, remarkable accomplishment. And people, I don't know if they appreciate how hard that is. Everybody's gone to school, everybody knows what the valedictorian was in high school or college, stuff like that. It's really a remarkable, remarkable accomplishment of both diligence and intelligence. Really, really impressive. Talk about some of the trends in the substance use disorder area because in the addiction world, the treatment world, I mean, what a fascinating and scary and challenging can be rewarding area. Tell us about some of the trends that you watch in that area and some of the trends you see in reimbursement too. Like where is it very difficult, where are things moving in the right direction or some of the challenges you see there.

[B]

Yeah, you know, it's a really quickly evolving area of medicine. It's one very new to payer reimbursement. The codes didn't even exist for payer reimbursement until Medicare developed a bundle for them about seven years ago. So I think, you know, the payer landscape is trying to figure out what reimbursement should look like, what the cost of those types of services look like. And it's unique for the payers because this is their highest cost patient population. So 85% of our patients are Medicaid and that's not unusual in substance use disorder. We are for 75% of our patients, their primary touch point with healthcare. They're not seeing a primary care physician, they're not seeing a dentist, they're not seeing, you know, OB GYNs even, gosh, when they are pregnant and we try to get them there, it's us or it's an emergency department or urgent care. That's very costly for the payers. I think they're finally in a position where they can actually calculate that cost. And that's been helpful for us because they're also a costly patient population to take care of. They come in to be treated for their sud, but they also need to be treated for some of these other co occurring chronic illnesses. And so that's, you know, more provider time, more expense for us because we're not just treating what our specialty is focused on, we're treating all of their issues when they show up at our doors. And so more recently we've been able to successfully develop some value Based care contracts. I think we're really charting some new territory with some of our payers and we have some great payer partnerships with those value based care contracts. But it's, it's evolving, the payer landscape's evolving. And then most recently, you know, when you have a patient population that's primarily Medicaid and you have anticipated Medicaid program cuts coming down following some federal legislation, I mean it's going to look even more different.

[C]

Right.

[B]

In 2028.

[C]

Right.

[B]

So now we're prepping for the next evolution with the reimbursement model for this, right?

[A]

No. And it seems like there's constant evol and changes. Just several years ago Medicaid was off fee for service. Now there's more and more states that have Medicaid, managed care, managed Medicaid and some companies that are very, very big in that, finding it more challenging now as those change as well. Fascinating talk about the addiction areas that you see that most of. Are there areas going in the right direction, the wrong direction or as a nation, are we just so in, in just such a challenging spot in terms of addiction?

[B]

Yeah. I think one of the things we've recognized is you can't just treat the addiction.

[C]

Right.

[B]

Most of our patients also have some form of mental health that you have to address as well. And then stepping beyond the healthcare needs, most of them have other social determinants of health issues, right? Housing insecurity, food insecurity, other things going on in their lives. And if you can't help them settle those issues, they don't really have the time to focus on their healthcare needs. So we're really trying to advocate for our payers to recognize some of these non traditional treatment team members such as community health workers, peers, individuals that have shared lived experience and care managers that can work with our patient population, try to address all of their non healthcare related needs so that then we can actually successfully develop and address their healthcare needs. Because if someone is struggling with sud, but you're not helping them find housing, stable job, food sources, it's just not going to be a priority if they're.

[A]

Basically exhausted by life, but by sort of housing or food insecurity or just life, very hard then to find the willpower, the strength to keep on going back, to keep on working on their addiction, to make that a priority. And it's so easy to slip back into it. It's hard enough for people that have everything to avoid slipping back into it, let alone people that have nothing and are really, really struggling. No, it's fascinating when you look at the year coming up and you folks have done such great work at Crossroads. It's amazing the growth and what you've done and the people you take care of. What are you most focused on and excited about as you move towards this next. The end of this year, into next year?

[B]

Yeah, we're really focused on expanding care in the states that we're already in. So we want to do this in ways that partner with both mobile healthcare and virtual health care. We've got a lot of brick and mortar, but it doesn't reach everywhere in the states that we're in. So one great example, we have a phenomenal payer partnership in North Carolina. And at the end of this year, we're going to launch our first ever mobile methadone clinic. It's a Winnebago that this wonderful company called Mission Mobile Medical has built out for us and it will have three stops a day. So it allows our Weaverville, North Carolina methadone clinic to now reach three other communities each day without having to build three additional brick and mortar costly facilities. And North Carolina is one of the early states to recognize licensure for a mobile methadone clinic. So this concept of mobile health I think is just in a lot of.

[A]

Rural communities that it'll go to.

[B]

Absolutely. So this payer had a grant coming out of some Hurricane Helene relief efforts from the state because we are up in the mountains of North Carolina and we couldn't reach everybody.

[C]

Right.

[B]

We need to come to them.

[A]

And the opioid epidemic has been. When you talk about the mountains of North Carolina, you talk about some of the mountains of Virginia, some of the Appalachia sort of, in some ways that was ground zero. A lot of the opioid epidemics and so forth. What are you seeing with opioid epidemic today? What's the temperature on that today?

[B]

It's still. Is prevalent, you know it. It's impacting more and more people every year, not less. And the, the drugs that are driving the addiction are evolving. Right. We're having all of these kind of man made substances hit the streets and it's hard for the medicine to keep pace with the evolution of the drug market essentially.

[A]

So we're talking about 100,000 deaths a year, 70, $100,000 a year. A year, 70 to 100,000 deaths a year from the opioids. And that's not really. There's been. Maybe it's not growing as fast as it was. It doesn't get as much attention as it did, but it still is a very real problem in our country.

[B]

Yeah. I think the number of people being impacted by SUD is still growing. The deaths. Sure. A lot of studies have shown the number of deaths tied to OUD has decreased. I think that's because people are living with it longer. I think there's also been a lot of efforts made to make Narcan available.

[C]

Right.

[B]

So people are living. Living through overdose incidents that used to kill them.

[C]

Right.

[B]

But we actually still see a growing number of people becoming addicted to these substances that are available on the streets.

[A]

Thank you. And you've been. You started your career six plus years at law firm doing all kinds of healthcare regulatory and transactional work. Then six or seven years at a surgery center company and also had some other testing, some other work and stuff like that. Now six, seven years at Crossroads Addiction Treatment Center. Talk about some of the different things you've learned over the years about different businesses and industries in health care. Just any sort of gestalt lessons you've learned, things that come to mind when you think about the different contrast of things you've done.

[B]

I think in health care, no health care areas alike.

[C]

Right.

[B]

They're all different. Every patient population is different. Even if you're a multistate health care operator, you could be within the same specialty, but your patient populations, their needs and how to access them are going to vary by state. I think that's abundantly true with behavioral health care. I mean, it's just every area of behavioral health care is unlike the other areas that you see in behavioral health care. So, yeah, I mean, I think with healthcare, I love the company I'm at because we're just really focused on the patient population. And it's like if we do right by them, we'll be successful as a company.

[C]

Right.

[B]

So it's less focused on like operations and monitoring, how you're functioning as an operational entity and more how are your patients doing? How are you setting them up for success? So that's been a nice evolution throughout my career to work with different areas of healthcare. But it's just really amazing how different they all can be from.

[A]

But they have a phenomenal culture. When the culture is really focused on how can we really be focused on the patient needs and other things. If we do them well, we take care of operations, we'll take care of themselves. But if we really focus on doing what's right for the patient and a patient need that, a patient clientele that's really in need, and then you must have like in all These situations, some patients like in every situation, not just behavioral health. Some that are really intent on trying to solve or work through their behavioral challenge. Others that are not as focused on it. And you must see a wide variety, a continuum of patients, like everything.

[B]

Yeah. I mean we even have, Right. We work with the criminal justice system and probation offices, drug courts. Some of the patients are there involuntarily.

[C]

Right.

[B]

Like that was a condition of their release, their probation. That's how they avoided a sentence.

[C]

Right.

[B]

So yeah, all spectrum, some that are there only because a family member, you know, pretty much said it's that or.

[A]

Right, you're out of the family.

[B]

You're out of the family. So that's an interesting patient population, I bet.

[A]

And one more question and Megan, I've watched your career. It's been great to watch, so impressed. Take a moment on what advice you would give to emerging leaders. What would you tell an emerging leader or just somebody trying to have a great career? I mean, talk a bit about that.

[B]

Yeah, I think you have to find something that you have a passion for and you enjoy. I wake up now and you know, some of my days are really long. Our employees start work at 4:30 in the morning and so I try to be available to them at those early hours. My husband loves that, that work schedule. But I, I love my job. I work up, I wake up every day just excited to go to, to work and, and make a difference. I think healthcare gives you that outlet. It's very easy to, to feel like you are, you know, saving lives, improving lives. But I think if you find something that you enjoy doing every day, you're going to be really good at it.

[C]

Right.

[B]

Even if you don't yet have the skill set for the role, you'll evolve and you'll, you'll develop those skills. As long as you wake up every day and have a passion and want to be there. I think people feel that, that you lead then.

[C]

Right.

[B]

They, they know you enjoy your job. It helps them enjoy their job every day as well.

[A]

Now when you're giving career advice, at some point you have to give career and educational advice to the, to, to the 6 and the 24 year olds. What advice would you give them about their careers? About going into the careers? I know it's early, they don't have to get there yet. But you were valedictorian early and stuff like that and went on to law school and just hit out of the park in law school too. I mean, does that set high expect both you and your husband are brilliant leaders. Does that set high expectations for the children and what advice you give them about careers?

[B]

Yeah, I mean, my husband and I are both in healthcare, and I'm in an area of healthcare where it really makes you value kind of today and not worry about tomorrow. So I think we're kind of pendulum swung back the other way. Like, we've been so focused on school and careers, and right now, like, I just want them to enjoy the time we have together.

[C]

Right?

[B]

Like life, develop their own passions, and then later on we'll find, like, what their career path is. But, you know, if they, like, want to wake up and, like, go be an art teacher, I'm like, great, let's. Let's take our class.

[A]

As long as they're, constructive, healthy adults, doesn't really matter what they do. And right now, obviously 6 and 4, you have to worry too much about the careers right now. Just one healthy, constructive, physically mentally healthy adults and so forth. But no, I think it's a great, great, great perspective. Megan, it is always a great pleasure to visit with you. I have been just amazed at watching your career growth and what you've done. I can't tell you how much I enjoy watching your success. And just fantastic.

[B]

Thank you, Scott. Thanks for having me on.