The 80 Million Podcast

AI and Digital Innovation in Medicaid — Promise, Peril and What to Buy

State Medicaid programs are under extraordinary pressure as they navigate federal funding uncertainty, H.R. 1 implementation, and health care cost growth that consistently outpaces both inflation and state revenue growth. States have myriad technology vendors pitching solutions to help alleviate those burdens, particularly around helping drive down the costs associated with certain clinical conditions and administrative functions. These technology solutions, increasingly, are AI powered and promise to be the differentiator for patients and Medicaid budgets alike. It can be daunting for state Medicaid leaders to evaluate which technologies deliver, where there are risks, and the types of structural changes that are needed for innovation to benefit the people Medicaid serves rather than the vendors selling to it. In Episode 3 of The 80 Million Podcast, host and 80 Million editor Patti Boozang speaks with Caroline Pearson, executive director of the Peterson Health Technology Institute (PHTI), and Jared Augenstein, senior managing director at Manatt Health, about what Medicaid leaders should believe — and question — about the explosion of artificial intelligence (AI) and digital health solutions entering the market.

Hospital at Home – The Bed Isn’t the Business Model Anymore

Innovate or die: That’s the conversation health systems are having as they navigate tightening finances due to new federal policy in Medicaid, including H.R. 1, a national health care affordability crisis, rising patient acuity and a workforce depleted by burnout.  Hospital at Home may signal a paradigm shift among hospital systems driven by “losing less money.” That’s good news for Medicaid. 80 Million Editor Patti Boozang sat down with UMass Memorial Health CEO Dr. Eric Dickson and Manatt Health’s Tom Robertson to explore what real innovation looks like in a hard operating environment.

Medicaid is on the Brink. What’s at Risk?

Medicaid, which is jointly funded by states and the federal government, has always operated under pressure, but this moment feels different. The program is facing a unique period of change, defined by factors that are significant on their own but far more consequential together. Centrally, the 2025 health care cuts to Medicaid and beyond, to the tune of $1 trillion over the next decade, will add nearly 10 million people to the uninsured ranks. These cuts will also trigger state budget holes and new funding gaps for the nation’s health care safety net. The funding cuts are compounded by new administrative burdens [https://80million.substack.com/p/how-states-can-incorporate-human] for consumers because of new Medicaid work reporting requirements [https://80million.substack.com/p/the-clock-is-ticking-on-medicaid] and other red-tape hoops people will need to jump through to get and keep coverage. Paperwork is a tried-and-true method for reducing enrollment, undermining decades of bipartisan efforts to streamline enrollment while ensuring program integrity through data-driven verification of eligibility. State Medicaid agencies will also feel the pinch as they operate with steep new administrative costs and fewer resources, and health providers who continue to serve low-income populations will be faced with patients churning in and out of coverage and a rise in uncompensated care. The “old Medicaid rubric” doesn’t make sense anymore. It’s one that we’ve moved beyond for good reason through the Affordable Care Act expansion. The vast majority of Americans support and value their Medicaid coverage, including their expansion coverage [https://80million.substack.com/p/too-poor-for-affordable-health-insurance?utm_source=publication-search],  as vital to keeping their families safe, healthy and financially secure.

Medicaid Is At An Inflection Point

For those of us at The 80 Million [https://80million.substack.com/], our name represents a vital segment of the American population — nearly one-fifth of the nation — who rely on Medicaid for their health, financial security and in some cases, survival. Today, the program stands at a critical inflection point. As Medicaid faces what many policy experts consider its most significant existential threat since its inception, we are expanding our coverage to meet the moment. Starting May 6, we are launching a special eight-episode podcast series to explore the seismic changes reshaping Medicaid and health care access more broadly in our country. Hosted by Senior Managing Director Patti Boozang, Season 1 of The 80 Million Podcast is about what's at risk at this moment in Medicaid, fiscally, operationally and politically, and where the program needs to adapt deliberately — not just to survive, but to get stronger. This is a time that demands solutions. Over the next decade, Medicaid is expected to see nearly $1 trillion in federal funding cuts from H.R. 1, new administrative hurdles that make getting and maintaining Medicaid coverage difficult, and federal policy shifts that limit the ability of states to raise revenue through state-directed payments and provider taxes. This new series reflects the very best of what defines our health group — deep expertise, meaningful collaboration and a commitment to shaping the future of care for the 80 million Americans who rely on Medicaid. Across the season, Patti brings together colleagues from Manatt Health and nationally recognized leaders to explore the most pressing challenges and opportunities facing the program today. Produced by Amanda Eisenberg, The 80 Million Podcast digs into technological innovations, FWA, and the operational and fiscal tradeoffs states are facing right now. Subscribe to The 80 Million here [https://80million.substack.com/]. Episodes will be available starting May 6 where you get your podcasts and, for subscribers [https://80million.substack.com/], in your inbox each week!