Ep 29 – Medicaid Reform and the One Big Beautiful Bill – Darin Gordon

EvidenceCare’s VP of Clinical Strategy, Carol Howard, sits down with Darin Gordon—Founding Partner of Speire Healthcare Strategies, President & CEO of Gordon & Associates, and former Director and CEO of TennCare—to break down what the recently passed “One Big Beautiful Bill” (OBBB) means for hospitals and Medicaid programs across the country. Drawing on his decades of public service and national consulting work, Darin explains how OBBB impacts Medicaid eligibility, funding, and operations—and what hospital leaders must do to stay ahead of these sweeping changes.The conversation covers critical topics like new work requirements for Medicaid recipients, the strain of provider tax reductions, looming DSH cuts, and the urgent opportunity for states and hospitals to collaborate on the $50B Rural Provider Relief Fund. Darin offers practical advice for hospital executives and Medicaid leaders navigating limited resources, policy uncertainty, and the push for sustainable innovation.Key Takeaways:Medicaid enrollment surged during COVID due to paused eligibility checks; OBBB initiates a major reset.Hospitals must act quickly to engage with their state agencies to access Rural Provider Relief Funds.Provider tax caps and DSH cuts will significantly pressure state budgets and hospital revenue streams.Hospitals should prioritize early engagement with Medicaid agencies and hospital associations to influence decisions.While OBBB doesn’t mandate value-based care, budget pressure may accelerate adoption of innovative models.Darin Gordon Bio:Darin Gordon is the Founding Partner of Speire Healthcare Strategies and President & CEO of Gordon & Associates. He previously served as the Director and CEO of TennCare, Tennessee’s Medicaid program, where he led one of the most operationally successful and fiscally sound Medicaid programs in the country. Today, he advises state agencies, hospitals, and health plans nationwide on Medicaid strategy, financing, and reform. View full bio---The BetterCare Podcast is produced by EvidenceCare.Sign up for email updates when new episodes are released.---Follow Darin GordonLinkedInFollow EvidenceCareLinkedInYouTubeTikTokX