The Becker's team is excited to announce the launch of our new CFO and Revenue Cycle podcast. Tune in for conversations with finance experts from the top hospitals and health systems. We'll discuss key trends and ideas to drive meaningful change in the industry. Look for Becker's CFO and Revenue Cycle podcast wherever you listen to episodes. This is Scott Becker with the Becker's Healthcare Podcast. I'm thrilled today to get to visit with editor in chief, Alan Condon. Alan is one of the great ones. Just a fantastic journalist, writer, and leader. Alan, thank you for joining us. I'm gonna tee us up. What are a couple of stories that you're watching currently in health care? Yeah. Absolutely. So this story, I think it's been on the tip of every hospital leader's tongue. It's something that they've been closely monitoring. Something we touched on last week in the podcast. But just to kind of as things progress a little bit and just based on a news report from this morning from the New York Times and our own Becker's coverage coupled with some some speaking with some recent CFOs. So that's again, as we move forward in the president Donald Trump's second term here, that's the Department of Government Efficiency, of course, led by Elon Musk, looking to reduce federal spending overall by $1,000,000,000,000. That's the goal. But we're hearing that Medicaid is emerging as a likely target for some of these cuts. What those cuts might actually represent now, we don't have a firm idea, but we do know that the Doge has requested access to CMS systems, which manage over $1,000,000,000,000 in annual payments. We know Elon Musk's cost cutting approach at Tesla, at SpaceX, at x, now obviously extends to federal spending, And he's really looking to hone in on what he claims are quote, unquote, fraudulent payments. So, of course, hospital leaders, health system leaders closely monitoring potential changes to Medicaid funding with clear concerns around financial stability. Of course, patient access are a real key component here. Nothing set in stone, but we do know that this is definitely on the books. Spells potential real problems for hospitals that are reliant on Medicaid reimbursements, are still recovering from from the particularly challenging couple of years. But I'll just kinda call out, Scott, I guess, a couple of potential Medicaid changes that that we were watching out for. Some some of the things that have been thrown about are potential stricter enrollment and renewal requirements, making it potentially harder for eligible individuals to maintain Medicaid coverage. Another one might be the elimination of provider taxes, which many states use to help finance Medicaid. And then a third one could be potential work requirements, which could lead to coverage losses among those low income adults. And the the only thing I think is an important caveat to mention here, major overhauls to Medicaid would would would obviously require congressional approval, remains up in the air given the Republicans' slim majority in the house, but, nothing is certain here. We don't know what happened to Fintivans or what these cuts might look like, but these are some of the things that are potentially on the table under Elon Musk's, Department of Government Efficiency. No. And and, certainly, it's, it is causing lots of concern, lots of uncertainty in a million different places in terms of, what will happen with these cuts, what the situation's gonna be, and so forth, how big the cuts will be. Obviously, Medicaid, aside from being a very, very, very important program for taking care of our nation's needy with health care is also a political football and that our governors love the control over the FISC they get through Medicaid. And so what a fascinating situation when the federal government takes a very different approach towards Medicaid than the last administration did, and we'll see how this goes. No. Alan, thank you for that. Tell us, what else are you watching closely? Absolutely. Yeah. So I'll jump into, another that just crossed the finish line. That's February 1. So this this was one that we're following for quite some time, and that's HCA Healthcare, big, big the largest for profit system in the country. They've officially closed on their acquisition of Catholic Medical Center, about a 330 bed system in New Hampshire. I think the reason why this deal is such a fascinating one is, obviously, it's a big for profit system acquiring a Catholic nonprofit system. Yes, New Hampshire is a relatively small market, a small state. But just to give readers some some insight into HCA's growing presence in that market now that that deal has has actually closed. So HCA has more than doubled its workforce in New Hampshire through this deal from about 2,500 employees now to nearly 6,000 employees. It now operates four hospitals in that state. So really significantly strengthening its market presence there. We do know that Catholic Medical Center's decision to sell was due to significant financial distress. It brought you near the brink of bankruptcy. It reported significant operating losses in recent years and that its debt level around about a hundred and $60,000,000. So part of that a hundred and $10,000,000 deal was that HCA would use proceeds to pay off some of Catholic Medical Center's creditors. It also has a deal in place to ensure that its Catholic identity remains there that remains maintains access to some key critical services and investing about $200,000,000 in the coming years to capital investments there as well. So, one small, small relatively small acquisition in a small part of the state, but just a really HCA, strategic acquisition there growing and strengthening its presence in New Hampshire, in in many other areas of the country as well. But that's the latest deal that we've seen closed from HCA. Fantastic. HCA is by far the best manager of the big for profit health systems and does an incredible job, fascinating to watch. So, Alan, two big stories. HCA finishes this acquisition. Governors, states, everyone a little bit concerned about what's gonna happen with Medicaid under the Trump administration or president Trump administration, and Elon Musk's taking a look at how money is spent there. Absolutely fascinating. Alan, anything else you're watching closely currently? That's it. I think the only thing I'd flag were, of course, HCA, the first, of the big for profits always to report their end of year 2024 results. We covered them last last week, but really looking forward to see how CHS and TENIF, reporting the results the coming weeks. So it'll be interesting to follow them and compare and contrast those for profit systems. So looking forward to covering those when indeed we cover those results in the co in the coming weeks, Scott. Hey, Alan. Thank you so much. Excited to keep on watching what's going on in the health care world. Thank you very, very much. Alan Congdon, Editor in Chief of Packers Health Care. Just phenomenal. Thank you, Alan. Thank you so much, Scott. Really appreciate it.