Medicaid cuts, drug pricing, rural hospital challenges, AI in healthcare, and why prevention is key to the future of U.S. healthcare. In this episode, Kristi Martin, former Chief of Staff at the Center for Medicare, examines the implications of recent Medicaid cuts, their impact on long-term care, and the ripple effects on private insurance and rural hospitals. She discusses the challenges of Medicare drug pricing negotiations, rising healthcare inflation, and the critical role of nonprofit hospitals in care delivery. The conversation highlights the need to rethink healthcare financing models, especially in rural communities, while exploring the opportunities and risks of AI in healthcare. Kristi also underscores the importance of preventative care, health equity, and value-based care in shaping better outcomes.

Title- Inside the Healthcare Policy Crossroads: Medicaid, Medicare, and Reform with Kristi Martin, Former CMS Leader

Key Timestamps:

• {00:00} Introduction to Kristi Martin and Healthcare Landscape
• {01:05} Impact of Recent Medicaid Changes
• {04:56} Long-Term Care and Medicaid's Role
• {09:12} State Variations in Medicaid Coverage
• {11:54} The Dichotomy of Healthcare Systems
• {15:45} Medicare Drug Pricing Negotiations
• {18:51} Challenges in Drug Pricing and Healthcare Spending
• {23:10} The Frustrations of Medical Education and Debt
• {26:02} The Role of Nonprofits in Healthcare
• {28:47} Diversity in Nonprofit Hospitals
• {34:09} Rethinking Financing for Community Hospitals
• {37:01} AI and the Future of Healthcare
• {42:22} The Importance of Preventative Care

Key Takeaways:

• Medicaid cuts will significantly impact long-term care services.
• The ripple effect of Medicaid disqualification will affect all insurance types.
• State variability in Medicaid coverage leads to unequal access to care.
• Drug pricing negotiations are a crucial step towards more equitable healthcare costs.
• Nonprofits play a vital role in providing affordable healthcare solutions.
• AI in healthcare presents both opportunities and risks that need careful regulation.
• Preventative care is essential for improving overall health outcomes.
• The healthcare system needs to be restructured to better serve rural populations.
• Healthcare spending growth is driven by various factors, including drug prices.
• There is a critical need for a public health focus beyond just healthcare services.

Guest Bio –Kristi Martin

Kristi Martin, Director at Canberra Collective and former Chief of Staff at the Center for Medicare, brings decades of experience shaping U.S. health policy. In this conversation, she unpacks the implications of recent Medicaid cuts, the strain on long-term care and rural hospitals, and the ripple effects across the healthcare system. Kristi also explores Medicare drug pricing negotiations, the role of nonprofits, and the need to rethink healthcare financing. She closes by examining AI’s risks in care delivery and emphasizing preventative care as essential to improving outcomes and advancing value-based care.

Connect with Kristi Martin on LinkedIn

About the Host – Roy Bejarano, Co-founder & CEO at SCALE Healthcare

Roy Bejarano is Co-Founder & CEO of SCALE Healthcare, the nation’s top healthcare consulting firm. As host of Analyzing Healthcare, Roy interviews leading executives, policymakers, and innovators shaping the future of healthcare strategy, MSO leadership, and system transformation.

Connect with Roy Bejarano on LinkedIn

Keywords:

healthcare policy, Medicaid, drug pricing, long-term care, ACA, healthcare spending, nonprofit healthcare, AI in healthcare, preventative care, community hospitals, healthcare technology, healthcare innovation, Healthcare System, Healthcare Podcast, Healthcare Trends, Healthcare Strategies, Thought Leaders, Industry Insights, Healthcare Governance, Leadership, MSO Strategy, Value-based Care