What happens when the former head of the CDC sits down to break down the future of American healthcare for employers?

In this episode of Margin of Care, host Kirk Czonstka speaks with Dr. Mandy Cohen, one of the most respected leaders in public health. Dr. Cohen shares what the pandemic changed for the better across the healthcare system, the risks employers face from major policy shifts like H.R. 1, and why the individual market is entering a dangerous cycle that will spill over into employer plans.

She also explains how mental and physical health integration is finally becoming real, why global health investments matter for US employers, and why the path out of the cost crisis requires employers to build a stronger culture of health and trust inside their organizations.

Dr. Cohen brings a rare combination of medical training, public sector leadership, and crisis-tested experience. This conversation gives employers a clear, unfiltered view of the policy and cost trends that will shape the next decade.

Key Takeaways
• Telehealth, data modernization, and cross-system collaboration were lasting improvements from the pandemic
• The individual market is entering a severe risk pool spiral that will raise premiums and reduce coverage options
• H.R. 1’s Medicaid changes will trigger major cost shifts into the employer market
• AI is not lowering costs in the short term and may increase trend due to high investment and payer-provider dynamics
• Employers must build a culture of health and trust to change behavior and manage long-term costs
• Global health surveillance is essential for pandemic preparedness, and declining investments increase national risk

What does it take to manage a half-billion-dollar healthcare budget and keep costs flat year after year?

In this episode of Margin of Care, host Kirk Czonstka talks with Brian Marcotte, former President and CEO of Business Group on Health and longtime benefits leader at Honeywell and Marriott. Brian shares how he balanced cost control with innovation—rolling all benefits costs into one budget, partnering with finance and procurement, and holding vendors accountable for outcomes.

He also breaks down how employers can adopt outcomes-based pricing, improve vendor ROI, and make benefits strategy more relevant to employees through real-world use cases and clear communication.

Key Takeaways:

• Why combining all benefits costs into one flexible budget drives better decision-making
• How close alignment with finance and procurement enables stronger ROI and vendor accountability
• Why outcomes-based pricing and performance guarantees are gaining traction
• How to use real employee scenarios to communicate value and increase engagement
• What employers should expect next as digital health solutions consolidate

When 15 million people lose healthcare coverage and more than a trillion dollars in federal funding disappears, every employer feels the impact.

Host Kirk Czonstka talks with Patricia Boozang, Senior Managing Director at Manatt Health, about the sweeping effects of H.R. 1—from coverage losses and premium increases to new Medicaid work requirements.

They discuss what these changes mean for employer-sponsored coverage, workforce wellbeing, and how businesses can prepare for the shifts ahead.

Key Takeaways:

• 15M people could lose coverage under H.R. 1, pulling $1T+ from the healthcare system.
• Employers can expect higher premiums and cost-shifting from public to private coverage.
• Medicaid work requirements (2027) will hit lower-income and hourly employees hardest.
• Employers should help workers navigate eligibility, maintain predictable schedules, and engage with state Medicaid agencies.
• Digital health, AI, and innovation can help offset rising costs and preserve access to care.

00:00 – Intro: The cost of losing coverage

01:10 – What’s inside H.R. 1 (“The One Big Beautiful Bill”)

03:30 – How 15M coverage losses impact employers

06:40 – Medicaid work requirements and 2027 changes

09:40 – What employers can do right now

12:55 – ACA marketplace shifts and premium hikes

15:20 – The trillion-dollar funding gap

18:00 – Rethinking affordability and innovation

20:45 – The rural health impact and digital care solutions

22:50 – Final thoughts: Why employer action matters

Liana Douillet Guzmán, CEO of FOLX Health, joins to discuss how traditional benefits models fail LGBTQIA+ employees and what leading employers are doing to fix it. She breaks down why inclusive care in name only isn’t enough, how FOLX is redefining access through affirming digital care, and why closing this care gap is good for people and business.

Digital health is entering a new era — one where informed consumers, smarter technology, and outcomes-based models reshape how care is delivered and funded. In this episode, Lee Shapiro of 7wire Ventures shares what he’s seeing across the industry, how employers are adapting, and why the next generation of startups will look different from those of the past.

With telemedicine waivers for Medicare enrollees expiring and the federal government investing in rural health, a strong telehealth strategy has never been more important. Danish Nagda, CEO and co-founder of Rezilient Health, talks with Margin of Care about the hybrid care model of the future -- and why physician quality is a core metric for improving primary care.

Large employers aren’t the only ones who can do direct contracting. In this episode of Margin of Care, Lee Lewis of the Health Transformation Alliance breaks down the ways small and mid-sized employers can be more nimble and drive better health outcomes for their covered lives, all the while managing costs. New approaches aren’t out of reach.

Subscribe to never miss an episode here: https://www.getgarner.com/margin-of-care-podcast

It’s no secret that health care costs are skyrocketing, but new research from the Business Group on Health indicates a 54% compounded increase over the last decade. On this episode of Margin of Care, the group’s president and CEO, Ellen Kelsay, reveals why health care costs are getting out of control — and how cell and gene therapy is a part of the puzzle.

Subscribe to never miss an episode here: https://www.getgarner.com/margin-of-care-podcast

Employers are now seen as the most trusted source of information. Dr. Vin Gupta argues in this episode of Margin of Care that employers should lean into their power and solve the pain points of health care utilization. With a different communication strategy, employers can make significant changes.

Subscribe to never miss an episode here: https://www.getgarner.com/margin-of-care-podcast

Healthcare consumerism is broken. On this episode of Margin of Care, Chris Hogan of Benefit Commerce Group argues that consumers are, at best, accidentally stumbling into quality health care — and that the industry has to better direct people to the right doctors.

Subscribe to never miss an episode here: https://www.getgarner.com/margin-of-care-podcast