023: How We Fixed Medicaid – Dr. Jim Rickards

On this episode, Dr. Jim Rickards explains how he transformed the medicaid delivery system for the state of Oregon. The incredible transformation is undeniable, and the improvements in health and outcomes demonstrate how there are ways to fix parts of our broken healthcare delivery system.

Dr. Jim Rickards is a healthcare leader with a focus on digital health innovation, value-based payment models, population health, and social determinants of health. He began his career as a physician and board certified radiologist. After serving as managing partner of a private radiology practice, Dr. Ricakrds helped lead the start-up of a community-governed healthcare plan, known as a Coordinated Care Organization (CCO).

While serving as the Chief Medical Officer for the Oregon Health Authority, he led novel payment initiatives, statewide healthcare transformation efforts, and evidence-based prioritization of healthcare benefits. Currently, he works as the Senior Medical Director of Population Health and Delivery System Collaboration.

Throughout the episode, we discuss Dr. Rickards book, Our Health Plan: Community Centered Healthcare That Works. In the book, He describes how they transformed the Medicaid delivery system through the creation of Coordinated Care Organizations. These integrative systems improved health outcomes for over a million medicaid members in Oregon. He now hopes to spread this success to other places in the US.

Learn more about Dr. Jim Rickards at his website, or order his book,Our Health Plan: Community Centered Healthcare That Works, on amazon.

Enjoy the episode!

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  • Interview begins [3:30]
  • Dr. Rickards’s background and how he got involved in healthcare. [3:58]
  • Jim describes how he began to transition to fix the healthcare problems he saw. [8:02]
  • Three ways we pay for healthcare in US. [8:21]
  • Creating a New Path in Oregon: The coordinated Care Model. [11:45]
  • Big challenges that Dr. Jim Rickards encountered while he’s trying to implement the new care model. [13:40]
  • Difference between CCOs and other types of organization [16:43]
  • Some specific examples of things that came together when the community united under this new model. [18:15]
  • Does the CCO program continued to evolve? [23:07]
  • The top 10 medications being prescribed to the medicaid population was opioids. [25:00]
  • What are some exciting things that Dr. Rickards saw when implementing the program? [25:48]
  • How is telemedicine helping with this new model? [27:15]
  • What would he change if he had the all the power in the world? [32:51]
  • Advice for the next generation of healthcare leaders [34:48]
  • Interview end [36:00]

Significant Quotes:

  • “Only about 10% of our health is determined by the medical care we receive.” [6:45]
  • “Just admit that you will study and try to learn a lot but you will never know it all.” [35:08]
  • “You gotta keep staying curious.” [35:37]


Website: jimrickardsmd.com

Book: Our Health Plan: Community Centered Healthcare That Works

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