Deputy Regional Inspector General Meridith Seife: Creative Problem Solving to Make Meaningful, Positive Change in People’s Lives

In her free time away from her workplace duties writing policy-rich reports as a Deputy Regional Inspector General, Meridith Seife often spends hours create oil paintings—a lifelong passion first nurtured by her artist mother.

“I’ve always enjoyed sketching and painting using different kinds of paints, but I especially like using oil paints, which provide such rich color and texture. You can build up layers of oil paint on a canvas, then go back repeatedly to add depth in color, change a form or even simplify your work as a particular piece calls for,” she explained.

Making painstaking refinements and adding rich layers of depth and nuance can also describe her approach to crafting evaluation reports as well.

As May is National Mental Health Awareness Month, it’s fitting to take a look at the most recent report she oversaw, “A Lack of Behavioral Health Providers in Medicare and Medicaid Impedes Enrollees’ Access to Care.”

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In this richly layered report, Meridith and her report team looked at 20 counties around the U.S., finding a significant lack of behavioral health providers—those treating both mental health issues and substance use disorder—to serve enrollees in traditional Medicare, Medicare Advantage and/or Medicaid managed care. The report found that only an average of fewer than five providers were available for every 1,000 enrollees, and some counties lacked even a single provider.

“In carefully designing and developing this review, we wanted to look at all three of these federal health care programs, which serve 133 million enrollees, which makes up over 40 percent of the US population. And we wanted to look at both rural and urban counties and include a look at providers who can prescribe medications,” she said. “Drilling down in these different populations and areas of our country can give us a nuanced, meaningful take on access to critical behavioral services.”

It’s important to note that there’s a significant need for behavioral health services in these federal health care programs. In Medicare, one in four enrollees are living with a mental illness, yet less than half of them receive treatment. In Medicaid the need is even greater, with almost one in three adult enrollees (29 percent) living with a mental illness, and one in five (21 percent) living with a substance use disorder.

Lastly, the report found that many enrollees had to travel long distances to see a provider: one in four enrollees traveled more than an hour to see their providers, with about one in ten traveling more than an hour and a half.

“I’m glad we crafted the review with so many details, because those questions yielded surprising and useful answers. One surprise is that so many enrollees needed to drive long distances for such care. Health care policy experts might have guessed that telehealth might ease the need to travel to see providers in person, but it’s also well known that the in-person connection is so important to treat mental illness and substance use disorder,” she said. Meridith added that it was also noteworthy that the lack of available providers was as significant in the Medicare program as it was in Medicaid, which has long had more pronounced scarcity of such providers.

From Childhood, Meridith “Fearlessly” Tackled Projects and Problems

Looking at Meridith’s family background and childhood, it’s clear that she’s always had a strong interest in creative pursuits and solving problems.

Born the daughter of a professor father and artist mother in Montgomery, Alabama, Meridith said she lived in 7 southern states in her first 10 years of life as her dad navigated a string of post-doc positions, eventually landing permanent position in Dallas at a local college.

“Although I was a shy kid, I was always fearless attacking activities and projects, eagerly going from reading and drawing/painting to outings. I’ve always loved learning new things and exploring,” she said. When they lived in the blue ridge mountains in Tennessee, Meridith recalled how her family traveled around in their orange Volkswagen bus to her dad’s performances as a blue grass musician while the kids roamed around exploring the surrounding wilderness and drawing the surrounding animals and trees.

“My family was born and raised in the south, with my parents born and raised in Georgia. My southern accent comes out when I’m relaxed or talking to family,” she said.

Always diving into projects from her earliest childhood days, Meridith enjoyed working on “assignments” when her mother enrolled in art school, with her mom developing art projects at her desk while kindergartner Meridith worked nearby on the kitchen table, using an anatomy textbook to sketch a human skeleton.

After graduating from the Arts Magnet High School in Dallas, Meridith enrolled at the Art Institute of Chicago to study visual arts, including oil painting. Her first job after college was working for an artist in Mexico, where she learned to speak Spanish. After graduation, Meridith’s longstanding problem-solving ability and Spanish speaking skills were useful when she landed a position with AmeriCorps helping people at a free medical clinic for uninsured people and teaching parenting classes for young mothers alongside direct line medical providers. Seeking to develop her knowledge of health care policy to help health providers best serve patients, Meridith enrolled in Syracuse grad school, graduating with a Master’s in public administration.

After graduation with her advanced degree in hand, Meridith moved to Washington, D.C. for an internship with the Congressional Research Service (CRS), which turned into a fulltime position writing reports about nursing homes, home and community-based services and the Temporary Assistance for Needy Families program. And it was a landmark point in her personal life as she married author and journalist Charles and in the next several years had two sons: Finn and Daniel.

After several years at CRS, Meridith landed a job as a senior analyst at the Government Accountability Office’s health care team, crafting a string of reports about health services provided in the Veteran’s Affairs Department and TRICARE health care systems. Three years into that position, Meridith’s husband landed a professorship in New York City, so Meridith searched for policy-focused job in that city and was “thrilled” to land the position of DRIG for the NY regional office in 2006.

Meridith Tackled “Seminal” Report on Food Safety, Spurring Changes to Boost Oversight

In this position at HHS-OIG’s Office of Evaluation and Inspections, Meridith led report teams working on several high-profile issues, including a body of work on food safety. In one study, Meridith and her team bought food items around the country and traced the products’ movement and inspections along the way to the point of sale. In other reports, the team evaluated the frequency and effectiveness of FDA’s inspections of food facilities. The team’s food safety work included more than a dozen key recommendations, later implemented, leading to new legislation requiring more rigorous timeframes for inspections and better traceability of the food supply.

“Everyone at the Inspector General’s Office keeps the people we serve at the center of what we do. We know that our hard work can improve people’s lives, and we push ourselves with people always in mind,” she said of HHS-OIG and its people-focused mission.

Reports on Enrollee Access to Needed Medical Services

After the passage of the Affordable Care Act (ACA), HHS-OIG ramped up work to gage enrollees’ access to health care services. Under ACA, many insured individuals were newly covered by insurance, and Meridith and her colleagues were among those in the agency who worked on “seminal” access-focused reports that determined whether these individuals with new insurance coverage under Medicaid could access health services with their coverage. Meridith and her report team found that often there were simply not enough health care providers, including doctors, to provide needed services to these newly insured Americans. More than half of the Medicaid providers could not offer appointments to enrollees at all, and many others had lengthy wait times for appointments, which could delay needed care.

“We also found wide variations in state requirements for how many providers Medicaid managed care plans needed to offer—ranging from 1/200 in some states, up to 1/2000 in others,” she said. “Although it’s a solid step forward for uninsured Americans to gain insurance coverage, if there are too few providers who take your insurance, that can still be a barrier to receiving needed health services.”

After describing the many reports she’s worked on over the years, Meridith reflected on the pride she feels in working at HHS-OIG and using her lifelong interest in creative problem-solving to develop reports on many pressing health care challenges in the U.S.

“Every study is a new adventure, involving learning new things and figuring out how these large systems function and how they can work better. I feel a responsibility to move the needle to help people and it’s gratifying to see our work serve the public,” she said. “And I love to dig deep to make a difference, to make meaningful, positive change for others.”