By David Hamilton

After more than 20 years in healthcare, I’ve seen change. Lots of it.

But what we’re facing now is unprecedented, and the foundation of Medicaid—and possibly Medicare--is on shaky ground.
If you're a provider or payer, this isn't just noise. This is an alarm bell.

No, no one’s ending Medicaid or Medicare. However, given the current environment, significant reductions to government healthcare programs appear virtually assured.

As it now stands, the House’s draft budget includes $880 billion in proposed Medicaid cuts over the next decade. That number is already rattling markets. Shares in Centene, the largest manager of state Medicaid programs, dropped more than 7% when the news hit in February. Major hospital systems whose patient mix may be overweight with Medicaid, like HCA and Community Health Systems, also saw immediate drops as investors braced for impact.

In healthcare, where margins are already paper-thin, reimbursement delays—or cuts—can’t be shrugged off. They’re existential.

We’re already seeing the anxiety firsthand. Hospitals, physicians, and patients everywhere in the country—blue states and red states, big cities and small towns and everywhere from Ohio and Illinois to California and South Carolina–are anxious about what comes next. These aren’t political talking points. The prospect of cuts poses dramatic business risks with direct consequences for millions of patients.

There’s a way forward
Here’s the good news: we’re not out of options.

AI is here. Not in theory. In practice. And it’s ready to help. Now.

AI-powered health management platforms are already showing what’s possible. They’re eliminating inefficiencies. Streamlining care management. Predicting problems before they happen. And this isn’t about replacing humans. It’s about helping them and the systems they work for operate smarter and faster so that clinicians can operate “at the top of their license” – in other words, focus on the sophisticated work that requires their substantial expertise and judgment.

Take predictive analytics. Platforms can analyze population-level data and flag early warning signs of disease outbreaks. That gives payers and providers lead time to act, prevent the spread, and reduce costs. According to a 2024 New England Journal of Medicine study, AI-driven interventions have concretely (read: measurably) helped hospitals get ahead of risks and improve outcomes.

A study last year by McKinsey found that “using currently available technology, payers could see net savings of 13 percent to 25 percent in administrative costs and 5 percent to 11 percent in medical costs as well as 3 percent to 12 percent higher revenue.”

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