Today, more than half of Medicare-eligible beneficiaries—nearly 35 million Americans—are enrolled in Medicare Advantage (MA) plans. These plans promise efficiency and added benefits compared to traditional Medicare, but a growing trend of MA payment delays and care denials is fueling concerns about insurer overreach.

What’s behind this surge in MA overreach, and what does it mean for providers and patients?

Brad Gingerich, Vice President at Ensemble Health Partners, joins this episode to unpack the incentives driving these behaviors, the impact on care delivery, and the solutions that could restore accountability and transparency. With years of experience helping hospital systems navigate managed care and revenue cycle challenges, Brad is the perfect guide through this complex and urgent issue.

Guest Bio:

Brad Gingerich is a healthcare executive with 15+ years leading managed care and revenue cycle operations for multihospital systems. He develops payer strategies and negotiates agreements — from fee-for-service to complex shared savings and population management — that balance provider priorities, strengthen payer partnerships and deliver organizational value. As a data-driven executive, he brings deep skills in analytics, contract modeling and financial forecasting, and is a recognized speaker and thought leader in healthcare finance.

Today, we are at the high-water mark of health coverage in America. More Americans than ever before benefit from the peace of mind that health insurance affords, with over 90 percent of Americans covered through private insurance, Medicare, Medicaid, or the exchanges.

With recently passed legislation and Administration actions that target Medicaid and implement new rules for marketplace enrollees, these coverage levels are set to decline.

This sets us up for a new challenge: what is our path forward for making health coverage accessible for those who need it, and how do we keep coverage affordable for those who have it?

Larry Levitt, KFF’s Executive Vice President for health policy, joins this episode of Hospitals in Focus to discuss this challenge, and the solutions available to policymakers. Larry is a veteran policy expert steeped in knowledge of Medicare, Medicaid, and the health care marketplace who understands just how central health coverage is to Americans’ health.

Guest Bio:

Larry Levitt is the executive vice president for health policy, overseeing KFF’s policy work on Medicare, Medicaid, the health care marketplace, the Affordable Care Act, racial equity, women’s health, and global health. He previously was editor-in-chief of kaisernetwork.org, which was KFF’s online health policy news and information service and directed KFF’s communications.

Prior to joining KFF, Levitt served as a senior health policy adviser to the White House and the Department of Health and Human Services, working on the development of the Clinton Administration’s Health Security Act and other health policy initiatives. Earlier, he was the special assistant for health policy with California Insurance Commissioner John Garamendi, a medical economist with Kaiser Permanente, and served in a number of positions in Massachusetts state government.

Levitt holds a bachelor’s degree in economics from the University of California, Berkeley, and a master’s degree in public policy from the Kennedy School of Government at Harvard University.

Recently passed Medicaid cuts are estimated to increase the number of uninsured by over 10 million. That number climbs to over 16 million when you factor in the upcoming expiration of the enhanced premium tax credits that enable hardworking Americans to afford to purchase their own health insurance from the exchanges.

Hospitals serve every patient who walks through their doors, regardless of their insurance or lack-thereof. These cuts will impact their ability to keep the lights on and reduce patients’ access to care – all of which has damaging effects on the surrounding community.

On today’s episode, Donald Baker, Regional President for Ardent Health’s Texas Region, takes us inside the UT Health East Texas hospital system. Donald explains just how damaging recently passed health care cuts, and the possible elimination of the enhanced premium tax credits, could be not just on patient care, but on the health and economic wellbeing of the entire East Texas community.

Guest Bio:

Regional President, Ardent Health’s – Texas Region (Lone Star)

Donald Baker serves as Regional President for Ardent Health’s Texas Region, known as the Lone Star Region. In this role, he oversees strategy development and operations for hospitals and health services in comprehensive delivery networks across Amarillo, Harker Heights, and East Texas, driving strategic growth, clinical excellence, and community-focused care.

Previously, Mr. Baker served as Chief Operating Officer and Chief Financial Officer for UT Health East Texas, where he led a comprehensive network that included nine hospitals, an academic medical center, regional rehabilitation facilities, freestanding emergency centers, more than 90 physician clinics, and a full continuum of outpatient and in-home healthcare services. Under his leadership, the system operated the region’s only Level 1 trauma center and maintained a robust emergency transport network with over 65 ambulances and four helicopters, serving a 40-county region with nearly 8,000 employees.

Before joining UT Health East Texas in 2020, Mr. Baker spent more than two decades with Hillcrest HealthCare System in Oklahoma, including 10 years as Market CFO. There, he supported seven hospitals, over 95 clinic locations, and 7,000 employees. His expertise spans managed care contracting, FP&A, financial operations, and executive leadership at large academic medical centers.

Mr. Baker currently serves on the Texas Hospital Association Board of Directors, the HOSPAC Board, and the Tyler Economic Development Council Board of Directors. He holds a bachelor’s degree in accounting from Langston University and is a Certified Public Accountant (CPA).