One in four Americans is enrolled in Medicaid, yet the system designed to support them is constantly at risk—underfunded, politically vulnerable, and often overlooked.

Dr. Alastair Bell, President and CEO of Boston Medical Center Health System, shares how his organization is reimagining what it means to care for underserved populations, while managing nearly 40% of Massachusetts’ Medicaid enrollees. In this conversation, we explore the financial realities of running an “essential” hospital system, the opportunities and pitfalls of Medicaid ACOs, and why AI might deepen inequity if essential providers are left behind.

We cover:

🏥 What makes an “essential” hospital system (and why the term matters)

📊 How BMC manages risk across one of the largest Medicaid plans in New

⚖️ Why risk adjustment in Medicaid populations is still falling short

💊 What the 340B drug pricing program really means for safety-net hospitals

🧠 The promise (and peril) of AI in essential care settings

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About our guest:

Dr. Alastair Bell oversees the comprehensive system strategy and operations of BMCHS' entities, including BMC, Boston Accountable Care Organization, Clearway Health, and the WellSense Health Plan.

Prior to joining in 2012, Dr. Bell was a leader in the North American payor and provider practice at McKinsey and Company, advising a range of national and international healthcare organizations and leading large-scale transformation programs. He received his Doctor of Medicine from the University of Oxford, his Master of Arts in physiology from the University of Cambridge, and his Master of Business Administration with distinction from Harvard Business School. Dr. Bell currently serves as co-chair of the board for the Boston Children’s Chorus.

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Managing Medicaid in Challenging Times | Boston Medical Center CEO Dr. Alastair Bell

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