Analyzing Healthcare

Priya Basu, Executive Head of the Pandemic Fund, discusses lessons from COVID-19 and the urgent need to strengthen pandemic preparedness worldwide. She highlights the Fund’s mission to support over 75 countries with investments in surveillance, laboratories, and workforce training, particularly in low- and middle-income nations. Basu underscores the importance of the One Health approach, recognizing the links between human, animal, and environmental health. She shares success stories from projects in India, Rwanda, and the Caribbean, and emphasizes how technology, digital tools, and international collaboration are reshaping public health. Her call to action: sustained investment to build resilient health systems.

Title – Can the World Ever Be Truly Ready for the Next Pandemic? Priya Basu, Executive at The Pandemic Fund

Key Timestamps:

• {00:00} Introduction to the Pandemic Fund and Priya Basu
• {02:57} The Need for Pandemic Preparedness
• {06:14} Operational Challenges in Pandemic Response
• {11:47} Country-Driven Approaches to Health Security
• {14:29} Lessons from COVID-19 and Future Preparedness
• {17:14} Successful Projects and Challenges Faced
• {23:59} The Role of Technology in Future Pandemics
• {27:00} Public Health Awareness and Community Engagement

Key Takeaways:

• COVID-19 exposed the world's lack of preparedness for pandemics.
• The Pandemic Fund aims to strengthen health systems in low-income countries.
• Surge capacity is essential for effective pandemic response.
• Countries must take ownership of their health security plans.
• Collaboration across countries is vital for pandemic preparedness.
• Investments in health security are cost-effective compared to the costs of pandemics.
• A multi-sectoral approach is necessary for effective health interventions.
• AI and technology can enhance data gathering and response coordination.
• Successful projects demonstrate the impact of the Pandemic Fund's investments.
• Building resilient public health systems is crucial for future preparedness.

Guest Bio – Priya Basu, Executive Head of the Pandemic Fund

Priya Basu is a global health and development finance leader with nearly 30 years of experience driving pandemic preparedness, health systems strengthening, and innovative finance. As the founding Executive Head of the Pandemic Fund at the World Bank, she mobilized $3B in seed capital and catalyzed over $6B in co-financing for 75+ countries. Previously, she led global initiatives at the World Bank, IMF, ADB, and UN, shaping landmark health financing mechanisms and advancing inclusive growth across regions.

???? Connect with Priya Basu 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:

Pandemic Fund, Priya Basu, COVID-19, pandemic preparedness, health security, global health, surveillance, workforce training, international collaboration, One Health, healthcare innovation, Healthcare Podcast, Healthcare Trends, Healthcare Strategies, Thought Leaders, Industry Insights, Healthcare Governance, Leadership, MSO Strategy, Value-based Care, Healthcare Trends and Innovations, Leading Healthcare Stakeholders, Healthcare Industry Insights, Healthcare Innovations, Healthcare Strategy, Healthcare Thought Leadership, Scale Healthcare, Roy Bejarano, Scale Community, Jason Schifman

Richard Zane of UC Health shares healthcare innovation strategies, tech adoption, patient care frameworks, and building a culture of collaboration.

In this episode, Richard Zane, Chief Medical and Chief Innovation Officer at UC Health, discusses the innovative strategies and frameworks that drive the healthcare system's approach to patient care and technology. He emphasizes the importance of understanding problem statements, the duality of his roles, and the collaborative nature of innovation at UC Health. The conversation explores successful initiatives, challenges in technology adoption, and the cultural aspects that foster a spirit of innovation within the organization. Zane also shares insights on measuring success and the future direction of UC Health's innovation efforts.

Title- Inside UCHealth: How Pragmatic Innovation Scales Across a $9B Health System

Key Timestamps:

• {00:00} Introduction to UC Health and Innovation
• {04:28} The Role of Technology in Healthcare Innovation
• {07:12} Dual Role of Chief Medical and Innovation Officer
• {12:27} Structure and Focus of the Innovation Office
• {13:54} Case Study: The Haystack Project
• {20:09} Challenges in Third-Party Technology Integration
• {24:00} Criteria for Evaluating Innovation Initiatives
• {27:48} Fostering a Culture of Innovation
• {31:53} Measuring Success in Innovation Projects
• {35:11} The Evolution of UC Health's Innovation Program
• {38:32} Future Directions for UC Health
• {40:22} Partnerships Beyond Hospital Providers

Key Takeaways:

• Innovation is a strategic pillar for UC Health.
• The role of Chief Innovation Officer is crucial for integrating technology and patient care.
• Understanding problem statements is key to effective innovation.
• UC Health's approach is hyper pragmatic and data-driven.
• The organization values partnerships with technology companies for co-development.
• Cultural transformation is essential for fostering innovation.
• Measuring success involves identifying clear metrics and outcomes.
• Phased deployments are preferred over pilot programs to avoid 'pilotitis'.
• The future of healthcare will involve more outpatient and home care solutions.
• UC Health aims to be a leader in innovative healthcare delivery.

About the Guest:

Richard Zane, Chief Innovation Officer at UCHealth and Professor of Emergency Medicine, shares how he is transforming healthcare delivery through digital innovation, AI, and data-driven care models. From emergency medicine leadership to pioneering virtual care strategies, Zane highlights UCHealth’s role in advancing patient outcomes, clinical efficiency, and system-wide innovation. This conversation offers critical insights for healthcare executives, providers, and innovators navigating the future of health systems.

linkedin.com/in/richard-zane-md-9b87b5a

linkedin.com/in/jasonschifman

Keywords

UC Health, innovation, healthcare technology, patient care, healthcare system, Chief Innovation Officer, healthcare delivery, technology adoption, healthcare partnerships, quality improvement, healthcare technology, Healthcare Podcast, Healthcare Trends and Innovations, Healthcare Strategies, Leading Healthcare Stakeholders, Thought Leaders in Healthcare, Healthcare Industry Insights, Healthcare Innovations, Healthcare Strategy, Latest Trends in Healthcare, Healthcare Thought Leadership, Scale Healthcare, Roy Bejarano, Scale Community, Jason Schifman

Richard Zane of UC Health shares healthcare innovation strategies, tech adoption, patient care frameworks, and building a culture of collaboration.

In this episode, Richard Zane, Chief Medical and Chief Innovation Officer at UC Health, discusses the innovative strategies and frameworks that drive the healthcare system's approach to patient care and technology. He emphasizes the importance of understanding problem statements, the duality of his roles, and the collaborative nature of innovation at UC Health. The conversation explores successful initiatives, challenges in technology adoption, and the cultural aspects that foster a spirit of innovation within the organization. Zane also shares insights on measuring success and the future direction of UC Health's innovation efforts.

Title- Inside UCHealth: How Pragmatic Innovation Scales Across a $9B Health System

Key Timestamps:

• {00:00} Introduction to UC Health and Innovation
• {04:28} The Role of Technology in Healthcare Innovation
• {07:12} Dual Role of Chief Medical and Innovation Officer
• {12:27} Structure and Focus of the Innovation Office
• {13:54} Case Study: The Haystack Project
• {20:09} Challenges in Third-Party Technology Integration
• {24:00} Criteria for Evaluating Innovation Initiatives
• {27:48} Fostering a Culture of Innovation
• {31:53} Measuring Success in Innovation Projects
• {35:11} The Evolution of UC Health's Innovation Program
• {38:32} Future Directions for UC Health
• {40:22} Partnerships Beyond Hospital Providers

Key Takeaways:

• Innovation is a strategic pillar for UC Health.
• The role of Chief Innovation Officer is crucial for integrating technology and patient care.
• Understanding problem statements is key to effective innovation.
• UC Health's approach is hyper pragmatic and data-driven.
• The organization values partnerships with technology companies for co-development.
• Cultural transformation is essential for fostering innovation.
• Measuring success involves identifying clear metrics and outcomes.
• Phased deployments are preferred over pilot programs to avoid 'pilotitis'.
• The future of healthcare will involve more outpatient and home care solutions.
• UC Health aims to be a leader in innovative healthcare delivery.

About the Guest:

Richard Zane, Chief Innovation Officer at UCHealth and Professor of Emergency Medicine, shares how he is transforming healthcare delivery through digital innovation, AI, and data-driven care models. From emergency medicine leadership to pioneering virtual care strategies, Zane highlights UCHealth’s role in advancing patient outcomes, clinical efficiency, and system-wide innovation. This conversation offers critical insights for healthcare executives, providers, and innovators navigating the future of health systems.

linkedin.com/in/richard-zane-md-9b87b5a

linkedin.com/in/jasonschifman

Keywords

UC Health, innovation, healthcare technology, patient care, healthcare system, Chief Innovation Officer, healthcare delivery, technology adoption, healthcare partnerships, quality improvement, healthcare technology, Healthcare Podcast, Healthcare Trends and Innovations, Healthcare Strategies, Leading Healthcare Stakeholders, Thought Leaders in Healthcare, Healthcare Industry Insights, Healthcare Innovations, Healthcare Strategy, Latest Trends in Healthcare, Healthcare Thought Leadership, Scale Healthcare, Roy Bejarano, Scale Community, Jason Schifman

David Lubarsky on safety net hospitals, trauma care, AI, value-based care, and leading large healthcare systems.

In this episode, David Lubarsky, President and CEO of Westchester Medical Center Health Network, discusses the complexities and challenges of managing a large healthcare system. He highlights the unique aspects of Westchester Medical Center, including its role as a major trauma center and safety net hospital. The conversation delves into operational challenges, financial pressures, and the importance of community care. Lubarsky also emphasizes the need for integration and synergy within healthcare systems, the impact of technology, and the significance of strategic partnerships in enhancing patient care.

Title- AI, Medicaid Cuts & Safety Net Hospitals: How Health Systems Survive and Innovate | Dr. David Lubarsky

Key Timestamps:

• {00:00} Introduction to Westchester Medical Center Health Network
• {02:38} Comparative Analysis of Healthcare Systems
• {05:13} The Complexity of Healthcare Integration
• {08:20} Operational Challenges in a Safety Net System
• {10:56} The Role of Trauma Centers in Community Health
• {13:41} Navigating Medicaid and Unfunded Patients
• {16:35} Contrasts in Safety Net Access Across States
• {19:22} The Future of Healthcare: Technology and Partnerships

Key Takeaways:

• Westchester Medical Center serves as a critical healthcare hub in New York.
• The center handles a significant number of inbound patient transfers, indicating its importance in the region.
• Operational efficiency and standardization are key goals for healthcare systems.
• Financial sustainability is a major concern for safety net hospitals.
• AI and technology can enhance healthcare delivery and efficiency.
• Community care and access to services are essential for underserved populations.
• The healthcare landscape is evolving with new partnerships and care models.
• State variations impact healthcare access and safety net responsibilities.
• Healthcare is a complex system with many interdependent parts.
• The future of healthcare will rely on innovative solutions and strategic collaborations.

Guest Bio – Dr. David Lubarsky, President and Chief Executive Officer Westchester Medical Center Health Network

David Lubarsky, MD, MBA, is the President and CEO of Westchester Medical Center Health Network, a vital safety-net health system serving millions across New York’s Hudson Valley. With prior leadership at UC Davis, Miami, and Duke, Dr. Lubarsky has spent his career expanding access for underserved populations while pioneering system integration and value-based care. In this conversation, he shares candid insights on Medicaid disenrollment, payer disruption, AI as “augmented intelligence,” and the growing role of retail health partnerships. His perspective offers MSO leaders, providers, and payers a real-world look at how healthcare can adapt and transform under pressure.

 Connect with Dr. David Lubarsky 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: Westchester Medical Center, healthcare system, trauma care, operational challenges, safety net hospitals, healthcare technology, strategic partnerships, community health, financial pressures, healthcare access, healthcare innovation, Healthcare Podcast, Healthcare Trends, Healthcare Strategies, Thought Leaders, Industry Insights, Healthcare Governance, Leadership, MSO Strategy, Value-based Care, Healthcare Trends and Innovations, Leading Healthcare Stakeholders, Healthcare Industry Insights, Healthcare Innovations, Healthcare Strategy, Healthcare Thought Leadership, Scale Healthcare, Roy Bejarano, Scale Community, Jason Schifman

David Lubarsky on safety net hospitals, trauma care, AI, value-based care, and leading large healthcare systems.

In this episode, David Lubarsky, President and CEO of Westchester Medical Center Health Network, discusses the complexities and challenges of managing a large healthcare system. He highlights the unique aspects of Westchester Medical Center, including its role as a major trauma center and safety net hospital. The conversation delves into operational challenges, financial pressures, and the importance of community care. Lubarsky also emphasizes the need for integration and synergy within healthcare systems, the impact of technology, and the significance of strategic partnerships in enhancing patient care.

Title- AI, Medicaid Cuts & Safety Net Hospitals: How Health Systems Survive and Innovate | Dr. David Lubarsky

Key Timestamps:

• {00:00} Introduction to Westchester Medical Center Health Network
• {02:38} Comparative Analysis of Healthcare Systems
• {05:13} The Complexity of Healthcare Integration
• {08:20} Operational Challenges in a Safety Net System
• {10:56} The Role of Trauma Centers in Community Health
• {13:41} Navigating Medicaid and Unfunded Patients
• {16:35} Contrasts in Safety Net Access Across States
• {19:22} The Future of Healthcare: Technology and Partnerships

Key Takeaways:

• Westchester Medical Center serves as a critical healthcare hub in New York.
• The center handles a significant number of inbound patient transfers, indicating its importance in the region.
• Operational efficiency and standardization are key goals for healthcare systems.
• Financial sustainability is a major concern for safety net hospitals.
• AI and technology can enhance healthcare delivery and efficiency.
• Community care and access to services are essential for underserved populations.
• The healthcare landscape is evolving with new partnerships and care models.
• State variations impact healthcare access and safety net responsibilities.
• Healthcare is a complex system with many interdependent parts.
• The future of healthcare will rely on innovative solutions and strategic collaborations.

Guest Bio – Dr. David Lubarsky, President and Chief Executive Officer Westchester Medical Center Health Network

David Lubarsky, MD, MBA, is the President and CEO of Westchester Medical Center Health Network, a vital safety-net health system serving millions across New York’s Hudson Valley. With prior leadership at UC Davis, Miami, and Duke, Dr. Lubarsky has spent his career expanding access for underserved populations while pioneering system integration and value-based care. In this conversation, he shares candid insights on Medicaid disenrollment, payer disruption, AI as “augmented intelligence,” and the growing role of retail health partnerships. His perspective offers MSO leaders, providers, and payers a real-world look at how healthcare can adapt and transform under pressure.

Connect with Dr. David Lubarsky 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: Westchester Medical Center, healthcare system, trauma care, operational challenges, safety net hospitals, healthcare technology, strategic partnerships, community health, financial pressures, healthcare access, healthcare innovation, Healthcare Podcast, Healthcare Trends, Healthcare Strategies, Thought Leaders, Industry Insights, Healthcare Governance, Leadership, MSO Strategy, Value-based Care, Healthcare Trends and Innovations, Leading Healthcare Stakeholders, Healthcare Industry Insights, Healthcare Innovations, Healthcare Strategy, Healthcare Thought Leadership, Scale Healthcare, Roy Bejarano, Scale Community, Jason Schifman

Transforming Pakistani healthcare with 7,500+ female doctors & 3M+ teleconsults—Sehat Kahani is closing access gaps through tech & cultural insight. In this episode, Dr. Sara Saeed Khurram, CEO of Sehat Kahani, unpacks how her tech-enabled platform tackles the country’s doctor-patient mismatch, leverages 7,500+ female doctors, and delivers over 3 million teleconsults. From cultural constraints to nationwide growth, hear how Sehat Kahani blends virtual clinics, corporate partnerships, and community care to improve outcomes. Dr. Khurram highlights the resilience of providers and the vital role of cultural values in healthcare delivery.

Title- Scaling Primary Care: Inside Sehat Kahani’s 60+ Clinics Across Pakistan | Dr. Sara Saeed Khurram x SCALE Community

Key Timestamps:

• {00:00} Overview of the Pakistani Healthcare System
• {12:53} The Birth of Sehat Kahani
• {23:40} Sehat Kahani's Growth and Impact
• {28:31} Healthcare Accessibility in Pakistan
• {29:45} Corporate Partnerships and Patient Utilization
• {31:28} Community Clinics and Rural Healthcare
• {32:56} Innovative Clinic Models and Mental Health Services
• {34:19} Corporate Healthcare Solutions and Cost Savings
• {36:11} Financial Models and Payment Structures
• {40:23} Provider Recruitment and Quality Assurance
• {45:29} Data Analytics and Outcome Tracking
• {49:44} Future Expansion and Technological Advancements
• {53:06} Cultural Resilience in Healthcare Delivery

Key Takeaways:

• Pakistan has a significant doctor-patient mismatch.
• Cultural barriers prevent many female doctors from practicing.
• Sehat Kahani was founded to address healthcare access issues.
• Telehealth can bridge gaps in primary care.
• The company has grown to include over 7,600 doctors.
• Corporate partnerships have expanded Sehat Kahani's reach.
• The app connects patients to doctors within 60 seconds.
• Sehat Kahani is exploring expansion into the GCC and Kenya.
• Resilience and hospitality are key strengths in Pakistani healthcare.
• The future includes enhancing technology and AI solutions.

About the Guest:

Dr. Sara Saeed Khurram, CEO and Co-founder of Sehat Kahani, is transforming Pakistan’s healthcare landscape. Her platform has delivered over 3.1 million telemedicine consultations, reactivated 8,000+ female doctors, and served 10 million+ lives—all while bridging primary care gaps in underserved areas. In this episode, she unpacks what’s broken in women’s health, how her full-spectrum model works, and why it’s yielding a 4:1 ROI for employers. A must-listen on innovation, inclusion, and the power of women-led healthcare reform.

linkedin.com/in/dr-sara-saeed-khurram-9a8873aa

linkedin.com/in/jasonschifman

Keywords

Sehat Kahani, telehealth, Pakistani healthcare, Dr. Sara Saeed Khurram, healthcare innovation, doctor-patient mismatch, corporate telemedicine, healthcare access, women in healthcare, healthcare technology, Healthcare Podcast, Healthcare Trends and Innovations, Healthcare Strategies, Leading Healthcare Stakeholders, Thought Leaders in Healthcare, Healthcare Industry Insights, Healthcare Innovations, Healthcare Strategy, Latest Trends in Healthcare, Healthcare Thought Leadership, Scale Healthcare, Roy Bejarano, Scale Community, Jason Schifman

Transforming Pakistani healthcare with 7,500+ female doctors & 3M+ teleconsults—Sehat Kahani is closing access gaps through tech & cultural insight. In this episode, Dr. Sara Saeed Khurram, CEO of Sehat Kahani, unpacks how her tech-enabled platform tackles the country’s doctor-patient mismatch, leverages 7,500+ female doctors, and delivers over 3 million teleconsults. From cultural constraints to nationwide growth, hear how Sehat Kahani blends virtual clinics, corporate partnerships, and community care to improve outcomes. Dr. Khurram highlights the resilience of providers and the vital role of cultural values in healthcare delivery.

Title- Scaling Primary Care: Inside Sehat Kahani’s 60+ Clinics Across Pakistan | Dr. Sara Saeed Khurram x SCALE Community

Key Timestamps:

• {00:00} Overview of the Pakistani Healthcare System
• {12:53} The Birth of Sehat Kahani
• {23:40} Sehat Kahani's Growth and Impact
• {28:31} Healthcare Accessibility in Pakistan
• {29:45} Corporate Partnerships and Patient Utilization
• {31:28} Community Clinics and Rural Healthcare
• {32:56} Innovative Clinic Models and Mental Health Services
• {34:19} Corporate Healthcare Solutions and Cost Savings
• {36:11} Financial Models and Payment Structures
• {40:23} Provider Recruitment and Quality Assurance
• {45:29} Data Analytics and Outcome Tracking
• {49:44} Future Expansion and Technological Advancements
• {53:06} Cultural Resilience in Healthcare Delivery

Key Takeaways:

• Pakistan has a significant doctor-patient mismatch.
• Cultural barriers prevent many female doctors from practicing.
• Sehat Kahani was founded to address healthcare access issues.
• Telehealth can bridge gaps in primary care.
• The company has grown to include over 7,600 doctors.
• Corporate partnerships have expanded Sehat Kahani's reach.
• The app connects patients to doctors within 60 seconds.
• Sehat Kahani is exploring expansion into the GCC and Kenya.
• Resilience and hospitality are key strengths in Pakistani healthcare.
• The future includes enhancing technology and AI solutions.

About the Guest:

Dr. Sara Saeed Khurram, CEO and Co-founder of Sehat Kahani, is transforming Pakistan’s healthcare landscape. Her platform has delivered over 3.1 million telemedicine consultations, reactivated 8,000+ female doctors, and served 10 million+ lives—all while bridging primary care gaps in underserved areas. In this episode, she unpacks what’s broken in women’s health, how her full-spectrum model works, and why it’s yielding a 4:1 ROI for employers. A must-listen on innovation, inclusion, and the power of women-led healthcare reform.

linkedin.com/in/dr-sara-saeed-khurram-9a8873aa

linkedin.com/in/jasonschifman

Keywords

Sehat Kahani, telehealth, Pakistani healthcare, Dr. Sara Saeed Khurram, healthcare innovation, doctor-patient mismatch, corporate telemedicine, healthcare access, women in healthcare, healthcare technology, Healthcare Podcast, Healthcare Trends and Innovations, Healthcare Strategies, Leading Healthcare Stakeholders, Thought Leaders in Healthcare, Healthcare Industry Insights, Healthcare Innovations, Healthcare Strategy, Latest Trends in Healthcare, Healthcare Thought Leadership, Scale Healthcare, Roy Bejarano, Scale Community, Jason Schifman

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

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

We hosted an exceptional roundtable with former CMS and CMMI leaders—Kristy Martin, Doug Jacobs, Liz Fowler, and Purva O’Rourke—who pulled back the curtain on how CMS operates, what drives policy, and how providers can productively engage the agency.

Highlights & Takeaways

• CMS culture = mission-first, non-partisan, expert-driven. Career staff see themselves as stewards of Medicare/Medicaid and keep the “trains running” regardless of administration.
• Playbook to engage CMS (no lobbyist required):
• Use public comment periods
• Request meetings
• Attend site visits
• Email program leads directly (staff will often route you to the right person)
• Don’t wait until there’s a compliance issue—build relationships early
• “Listening mode” is normal. During rulemaking windows CMS may not respond in the moment—but silence can mean your input landed and is being weighed.
• Accountable care remains the north star. CMS wants beneficiaries in models where a “quarterback” is accountable for cost and quality, with on-ramps for smaller/rural providers and emphasis on provider-led governance.
• Primary care signals are positive. Recent PFS proposals maintain/expand advanced primary care, CCM/remote monitoring, and navigation codes—an encouraging sign for longitudinal, team-based care.
• Site-of-service migration will continue. CMS is actively evaluating procedures moving from inpatient to outpatient/ASC when safe and cost-effective—stakeholder comments matter here.
• Transparency is advancing. Price-posting requirements and NSA data are maturing; expect a more navigable market over the next few years as datasets standardize and tools improve.
• Behavioral health is moving from “supplemental” to integrated. New codes, broader provider definitions, and ACO/primary-care integration are building blocks—further progress may require Congressional authority.
• AI + burden reduction are live priorities. CMS is exploring AI for fraud detection and administrative simplification; proposals that reduce provider burden are welcome.

Practical “Do / Don’t” from the Panel

• DO:
• Comment on proposed rules
• Share data, outcomes, and real-world constraints
• Introduce innovative models early
• Follow up even if CMS can’t discuss specifics
• DON’T:
• Assume only large systems get heard
• Wait until there’s a problem
• Read “quiet” meetings as failures

Why it matters for MSOs & Health Systems

• Strategy: Align roadmaps with accountable care, primary-care enablement, and behavioral integration.
• Operations: Build capabilities around care management, RPM/RTM, and documentation to capture value under evolving codes.
• Advocacy: Engage both CMS and Congress—some levers (e.g., broader BH coverage, physician payment reform) are statutory.