70% of Rural Hospitals Are Losing Money: The Crisis Coming to a Town Near You with Peter Justen

On this episode of The Ty Brady Way, Ty sits down with Peter Justen, a serial entrepreneur, efficiency expert, and the man on a mission to fix one of the most broken application processes in America. Peter’s background reads like a masterclass in reinvention, from driving a bulldozer as a kid in a town where your options were the steel plant or the auto factory, to building nationwide mortgage banking companies, testifying on Capitol Hill, and constructing entrepreneurship ecosystems for cities, state governments, and even the nation of South Africa. What ties all of it together is a single question he has asked his entire life: why not? Peter’s pivot into the world of Medicaid was not a calculated business move. It was personal. When he moved his mother to Virginia in her mid-eighties and tried to get her enrolled in a program she was perfectly qualified for, what should have been a straightforward process turned into a four-month ordeal of back-and-forth letters, confusing questions, and daily phone calls filled with fear and anxiety from a woman who just needed to know if she could afford her medication. One of the application questions asked his 85-year-old mother if she was pregnant. That was the moment Peter decided someone had to fix it, and if not him, then who? What he built is remarkable in its simplicity. By hiring a data science firm to identify only the questions that truly matter, Peter’s team reduced Virginia’s 200-plus question application down to roughly 20. The entire process now takes about 12 minutes from start to finish, pulling third-party verified data to auto-populate the application rather than burdening already-stressed applicants with information they may not have on hand. For the states, the result is an application that arrives complete and pre-verified, cutting processing time and costs by roughly 75%. One cost-benefit analysis for a mid-sized southern state projected savings of approximately $2 billion per year after paying for Peter’s platform. The conversation takes a powerful turn when Peter connects this work to the rural hospital crisis gripping America. Roughly 70% of rural hospitals are currently operating in the red, driven largely by $42 billion a year in uncompensated care for patients without insurance. Peter explains that an estimated 35% of those patients are eligible for Medicaid but never apply due to the intimidating complexity of the process. His solution is to embed the 12-minute application directly into hospital workflows, at the appointment desk, in the emergency room, anywhere a patient first makes contact, so that the Medicaid clock starts ticking immediately. Since Medicaid reimburses from the date of application rather than the date of approval, even a same-day submission can make an enormous financial difference for both the patient and the hospital. Ty and Peter also dig into the fraud problem that is costing the Medicaid system an estimated $75 billion a year, with Minnesota’s scandal making headlines as just one example of a nationwide issue. Peter is clear that the answer is a surgical scalpel, not a machine gun. Cutting fraud without cutting off the people who genuinely need care is the only acceptable outcome, and his platform is built to detect fraud before it enters the system rather than chase it afterward. He shares the story of a 43-year-old man undergoing chemotherapy who lost his Medicaid coverage simply because he was too sick to complete the renewal application, a consequence that is both heartbreaking and entirely preventable. Peter closes with a message he wants everyone to hear: Medicaid is not just for poor people. It is for people who need help, and the social stigma surrounding it is keeping eligible Americans from accessing care they have every right to receive. He has also written a book on the history of Medicaid and is giving away free copies to anyone who reaches out directly. His contact information will be in the show notes. 🔗 https://www.linkedin.com/in/peterjusten 🎙️ @thetybradyway   As always, we would like to hear from you! Email us at [email protected] Or DM us on Instagram @thetybradyway