Siftwell

Mission & Margin

Technology EN ↓ 4 episodes

Mission & Margin is a show celebrating the executives, policy advisors, and turnaround specialists transforming managed care organizations from the inside out. Hosted by Trey Sutten, CEO of Siftwell and former health plan CEO and Medicaid CFO, the podcast explores how leaders are implementing AI, improving quality, uncovering revenue opportunities, and preparing plans for what’s next across Medicaid, LTSS, SNIP, behavioral health, and complex populations.

Author

Siftwell

Episodes

Analytics Teams Keep Hiring Analysts. That's the Problem | Bradley Riley 09.07.2026 40:37

Bradley Riley's biggest fix for his analytics team at Longevity Health wasn't a new dashboard or a better data pipeline. It was hiring someone with zero analytics background. Riley, VP of Analytics, Medical Economics, Reporting, and PMO, pulled someone from clinical operations into his data team full-time and built a role from scratch — the clinical delivery lead — to translate between ana...

$11M for one patient's drug: why gene therapy threatens plans more than GLP-1s | Peter Marino 25.06.2026 26:58

One member at Neighborhood Health Plan of Rhode Island carries an $11 million annual maintenance drug. For that same cost, Peter Marino says he could vaccinate the entire state for the flu. Peter tells Trey why community plan leaders should be far more worried about gene therapy than GLP-1s. Peter has run Neighborhood as CEO for 11 years and grew the plan from 92,000 to 220,000 members and $450 mi...

'We can do anything, we can't do everything': TPA switch, ACA exit, 30% growth | Mark Rakowski 11.06.2026 33:24

Chorus Community Health Plans started with 30 members inside a children's hospital system that already held 90% inpatient market share. This wasn't a bed-filling play. Mark Rakowski , President of Chorus and SVP at Children's Wisconsin , tells Trey how that origin drove the decision to exit the ACA marketplace after medical and pharmacy trends hit 40-50% in 2025, and to redirect every available do...

Introducing Mission & Margin: a New Podcast for Community Health Plan Operators 21.05.2026 1:40

We're excited to launch Mission & Margin, a podcast for the executives running today's most complex health plans. In each episode, Trey Sutten sits down with the operators doing the work to share the strategies, decisions, and lessons that don't make it into press releases. The Plans Worth Fighting For The community health plan landscape has gotten harder. Capital constraints, subs...