How Medicaid Is Losing Billions of Dollars Due to Mispricing and Lobbying Power - Christopher Drumm

In this episode of When Health Freezes Over, I am joined by Guest Christopher Drumm, Founder of Drumm and Daughters LLC to unpack decades of experience at the intersection of healthcare, politics, and public service. From grassroots ward politics in Philadelphia to shaping Medicaid policy across multiple states, Christopher shares an insider’s view of how managed care evolved, and where it’s headed. They talk about the realities behind lobbying, the challenges facing Medicaid today, the financial pressures on health plans, and the growing crisis of rural hospitals. Along the way, Christopher offers candid stories, practical insights, and a deeply personal perspective on prevention and public health. Christopher Drumm is a Philadelphia native and seasoned healthcare lobbyist with a career spanning local, state, and federal government. He began in grassroots politics in the 1980s, becoming the youngest leader of Philadelphia’s 63rd Ward. Christopher later spent over a decade at Saint Joseph’s University securing major public funding initiatives before leading government affairs at AmeriHealth Caritas for 20 years. There, he played a key role in expanding Medicaid managed care programs across multiple states. Today, Christopher runs his own consulting practice, focusing on healthcare policy, distressed hospital turnaround efforts, and strategic advocacy. Expect to Learn: How lobbying actually works behind the scenes in healthcare Why managed Medicaid exists and how its role has evolved The real reasons health plans are struggling financially today Key tensions between states and insurers Lessons from major Medicaid rollouts Why rural hospitals are collapsing and what it takes to save them The importance of prevention and social determinants of health How politics, personalities, and trust shape healthcare policy decisions Timestamps: [00:00] – Teaser [01:43] – Introduction of Christoper Drumm [03:06] – Growing Up in Mayfair & Early Influences [04:34] – Entry into Politics & First Campaign Experience [06:01] – Transition into Lobbying [08:32] – Work at Saint Joseph’s University [11:16] – Joining AmeriHealth Caritas [13:39] – What Lobbying Actually Involves [14:407 – Building Relationships in New States [19:29] – Role of Managed Care in Medicaid [22:18] – Advocacy Challenges & Political Realities [24:28] – Iowa Case Study: When Medicaid Goes Wrong [31:05] – Policy vs. Personality in Decision-Making [32:02] – Key Tensions Between States & Health Plans [33:50] – Quality of Care in Medicaid [37:32] – Why Health Plans Are Struggling Financially [40:11] – Current Work: Distressed Hospitals [48:12] – Rural Health Transformation Programs [52:25] – Closing Thoughts Follow Guest Christopher Drumm: LinkedIn:   / christopher-drumm-17697110   Company Website: https://www.drummanddaughters.com/ Follow Me On: LinkedIn:   / omar-haq1   Company Website: https://www.mushincg.com/ Instagram:   / mushincgllc   Tiktok:   / uberactuary   Follow Us On: YouTube:    / @mushincg   Spotify: https://open.spotify.com/show/3bRobaB... Apple Podcast: https://podcasts.apple.com/pk/podcast...