All Episodes
Season 1 & Season 2
The Billion Dollar Question
Medicaid spending exploded 82% in five years while beneficiary growth was only 52%. Twenty-five providers control 40% of all spending. We follow the money.
“Nobody's really looking at them. And when you do look, the system doesn't even want to tell you who they are.”
The Invisible Giant
NPI 1417262056 billed $7.18 billion over seven years — 90 million claims, 35,000 per day. But its identity is redacted. Who is the invisible giant?
“I have a number. I have billing data. But I don't know who this is.”
The T1019 Economy
Personal care services code T1019 accounts for $122.7 billion — 11.2% of all Medicaid. It grew over 100% while the system grew 52%. One procedure code tells the whole story.
“Personal care is now bigger than entire state healthcare systems. And it's growing faster than anyone expected.”
Three Degrees of Separation
155 top providers. 2,740 connections. 9 communities. The Medicaid system is not random chaos — it has hidden structure. And a few providers hold it all together.
“The Medicaid system isn't random chaos. It's organized into communities. And a few providers hold them all together.”
The 2024 Cliff
Spending dropped 76% in 2024. Ten million people disenrolled. Is it a collapse or a reset? Understanding who got left behind tells us everything.
“It's not a collapse. It's a reset. And understanding who got left behind tells us everything.”
Who Owns Medicaid?
Private equity is buying up Medicaid providers. Solo practices become aggregators become financial platforms. The system is consolidating — and nobody tracks who owns what.
“The Medicaid system isn't just healthcare. It's becoming a financial asset class.”
The Price Is Wrong
The same procedure billed at 5x to 10x different rates in the same state. In any normal market, this triggers antitrust investigations. In Medicaid, it is invisible.
“In any normal market, this much price variation would trigger antitrust investigations. In Medicaid, it's invisible.”
The Reckoning
Season finale. We bring all threads together — growth, concentration, networks, ownership, pricing. Data does not lie. But silence does. And we have to break it.
“Data doesn't lie. But silence does. And we have to break it.”