dianne faup founding partner of speire healthcare strategies, LLC biography photo


Tom Betlach


Tom joined Speire 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 the last nine 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. Arizona remains one of the lowest cost long-term care programs nationally and Arizona has maintained high levels of home and community-based placement for persons with long term care needs

Known for working across agencies, 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 delivering 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 lead 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.

Tom serves as a critical Medicaid and health policy resource for policy makers both in Arizona and nationally. He led Arizona in partnership with the federal government to create new tools for states to successfully improve services for those dually eligible for Medicaid and Medicare. On the national level he is seen as a leader on how to serve the dual eligible population and has testified before Congress on multiple occasions on how to effectively care for this complex population.

As a national leader, 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) and is a member of the Congressional Budget Office Panel of Health Advisers.

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.