Medicaid is an under appreciated innovation lab | Dr. Chris Cogle (Florida Medicaid)

Martin talks with Dr. Chris Cogle, author of the recently released book Public Startup and health care policy expert, about how Medicaid agencies sit at the intersection of medicine, policy, quality, data, finance, and operations to improve care for millions while managing limited taxpayer resources. 

They discuss Medicaid as an under appreciated innovation lab, what makes pilots succeed or fail, and how state–managed care organization relationships have evolved into partnerships focused on accountability, risk, and care coordination—especially in Florida’s large managed-care program. 

Chris explains where value-based care works (defined populations, actionable data, simple contracts) and where it struggles (small cohorts, heavy admin burden), and how Medicaid-born models like telehealth and community-based care can diffuse into commercial and Medicare Advantage. 

He also offers guidance for policymakers, agencies, and startups: treat Medicaid as a platform, invest in data, reward outcomes, create safe pilot pathways, and lean into Medicaid rather than avoiding it.

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