2026 Nashville Health Care Council D.C. Delegation Recap and Insights

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May 6, 2026 2:37:41 PM

Sixty-six delegates from the Nashville Health Care Council convened in Washington, D.C. for an immersive two-day experience focused on the policy, politics, and innovation shaping the future of healthcare. The year marked the Council’s 23rd annual D.C. Delegation and its first since becoming an independent organization. Through a series of thought-provoking sessions, delegates gained a deeper understanding of the current political landscape, emerging policy priorities, and the opportunities ahead for healthcare leaders navigating a rapidly changing environment. Get an inside look at the D.C. Delegation with the following session recaps.

Read the pre-D.C Delegation reference materials here.

The Political Landscape in Washington: Policy and Priorities Under the Current Administration

Moderator: Mark Tipps, Operating Partner and Counsel, Frist Cressey Ventures

Panelists: Liz Jurinka, Operating Director, Healthcare Policy, Vistria PRG | Monica Popp, Founding Partner, Marshall & Popp

The opening day of the Nashville Health Care Council’s D.C. Delegation began with a timely overview of the political and policy forces shaping healthcare in Washington. Mark Tipps moderated a panel of seasoned political insiders who offered thoughtful perspectives on the complex dynamics influencing healthcare policy, congressional priorities, and the broader operating environment for industry leaders.

Popp focused on the political mechanics driving near-term healthcare policy, emphasizing the importance of congressional control and the likely impact of the midterm elections. She highlighted how even narrow shifts in power, particularly in the House, could increase oversight activity, constrain bipartisan progress, and shift attention toward investigations alongside, or at times instead of, policy advancement.

Jurinka offered a complementary perspective centered on the policy implications and economic constraints shaping healthcare reform. She emphasized that while policymakers remain open to engaging on healthcare changes, stakeholders should expect tradeoffs, as policy fixes are unlikely to move forward without concessions. She also pointed to the tension between public perception and economic reality, noting that while healthcare costs remain a central concern, spending growth has been more moderate than projected, complicating the narrative for policymakers trying to balance affordability with fiscal constraints.

Together, the discussion illustrated a healthcare policy environment defined by political volatility, fiscal pressure, and heightened scrutiny of industry stakeholders. For healthcare leaders, the session reinforced that progress will depend not only on policy innovation but also on navigating governance, compromise, and the competing incentives shaping decisions in Washington.

An Evolved Healthcare Policy Landscape

Moderator: Lance Leggitt, Senior Vice President of Government Relations, TeamHealth

Panelist: Brian Blase, Ph.D., President, Paragon Health Institute

The fireside chat examined the policy and market forces reshaping federal healthcare programs, grounding national debates over access, affordability, and sustainability in the practical realities facing healthcare leaders. Drawing on his experience in state and federal healthcare policy, Leggitt emphasized the importance of ongoing dialogue between policymakers and the healthcare community.

Set against a backdrop of rising healthcare costs, growing federal budget pressure, and continued debate over the future of coverage, the discussion explored how policy decisions across the ACA, Medicaid, and Medicare are influencing access, affordability, program integrity, and long-term sustainability. Blase framed many of these issues through the incentives embedded in current program design and the broader challenge of sustaining federal healthcare programs amid mounting fiscal pressure.

Blase offered a detailed perspective on the implications of expired enhanced ACA subsidies, noting shifts in enrollment patterns, plan design, and consumer affordability as some individuals move into zero-premium plans with higher deductibles and greater cost sharing. He also discussed potential policy approaches to expand coverage options, including short-term plans, catastrophic plans, and non-network insurance models. The discussion then turned to Medicaid reforms, including work requirements, provider taxes, and directed payments, with Blase connecting those issues through the broader challenge of aligning state and federal incentives.

The conversation also addressed fraud, waste, and abuse, Medicare Advantage, consolidation, behavioral health, and the role of AI in healthcare. Throughout the exchange, Leggitt guided the discussion toward the practical implications for healthcare leaders, highlighting the importance of engaging policymakers with real-world operational insight. Together, the session underscored a policy environment increasingly focused on affordability, accountability, program integrity, and the difficult tradeoffs required to sustain access across federal healthcare programs.

Rural Health Transformation

Moderator: Jason Zachariah, President & COO, Lifepoint Health

Panelists: Emily Chen, Senior Advisor, Office of the Administrator, CMS | John Fryer, Chief Growth & Corporate Development Officer, Lumeris | Alan Morgan, CEO, National Rural Health Association

The conversation centered on a defining question for rural healthcare: how to turn a major federal investment into measurable, sustainable improvements in access, outcomes, and care delivery. Zacariah framed the conversation around the program’s intended impact, state-level implementation, and the role healthcare leaders can play as the initiative moves from policy design to execution. The panel made clear that rural health should not be viewed as a smaller version of urban care, but as a distinct delivery environment where patients often have the greatest needs and the fewest available options. Speakers emphasized that the program creates an opportunity to move beyond short-term funding debates and test more sustainable models that connect hospitals, clinics, schools, community organizations, technology partners, and state agencies in support of better outcomes.

A central theme that emerged from the panel was the need to balance the promise of historic investment with the operational discipline required to translate funding into sustainable rural health transformation. Chen framed the program as a historic chance to reduce disparities for rural Americans by advancing prevention, sustainable access, workforce development, innovative care, and technology-enabled solutions. Morgan emphasized that rural transformation must keep hospitals and local care access points central to the work, given their role as safety net providers, economic engines, and anchor institutions in many communities.

At the same time, the panelists cautioned that the scale of the investment does not guarantee success. Fryer underscored the opportunity to deploy meaningful solutions at scale, but warned that rushed implementation, narrow procurement processes, and disconnected tools could create more fragmentation instead of true transformation. Panelists also noted that technology, including AI, holds significant promise, but only if rural providers have the infrastructure, data capabilities, and local input needed to use those tools effectively.

The panel also highlighted the importance of variation across states, measurable outcomes, and long-term sustainability. States will play a central role in setting priorities and distributing funds, while providers and community partners will be on the front lines of implementation. Across the discussion, the speakers reinforced that rural transformation will require more than funding alone. Success will depend on coordinated execution, local co-creation, responsible use of technology, and a disciplined focus on solutions that are measurable, sustainable, and centered on the needs of rural patients and communities.

Medicaid and Medicare Innovation

Moderator: Marty Bonick, President & CEO, Ardent Health

Panelist: Abe Sutton, Deputy Administrator and Director, CMS CMMI

At a time when healthcare leaders are being asked to improve outcomes, lower costs, adapt to rapid technological change, and respond to rising patient expectations, the conversation examined how federal innovation policy can better reflect the realities of delivering care. It centered on a core challenge facing healthcare policy and operations: how to design incentives that make affordability, innovation, and accountability achievable not only in theory, but in the day-to-day decisions of providers, payers, innovators, and patients.

Sutton reflected on how his experience in Nashville’s healthcare ecosystem shaped his approach to policymaking, noting that policy ideas must be tested against the practical realities of care delivery, data collection, attribution, and provider behavior. He framed affordability as one of the central challenges facing the system, driven in part by healthcare’s slower productivity growth compared with other sectors. He also emphasized that policy must create pathways for technology to reduce the cost of clinical care delivery rather than solely improve administrative efficiency.

The discussion also explored CMMI’s evolving model portfolio, including approaches tied to digital therapeutics, accountable care, prevention, patient empowerment, and models built around accountability for Medicare risk in defined geographies. Sutton emphasized the importance of aligning financial accountability with decision-making authority and moving away from models that rely only on voluntary upside participation. Bonick guided the conversation toward practical takeaways for healthcare leaders, including the need to provide CMS with specific, operationally grounded feedback that explains how policy changes affect business decisions and care delivery.

Together, the session underscored that healthcare innovation will depend on more than new models or technologies alone. Progress will require clearer incentives, stronger accountability, more practical use of data, and sustained engagement between policymakers and the leaders responsible for delivering care.

Breakout Sessions

Breakout sessions offered a deeper dive into key topics while at delegation:

Technology and Trust led by Steven Posnack, MS, MHS, Principal Deputy Assistant Secretary for Technology Policy and Principal Deputy National Coordinator for Health Information Technology.

Where are we and where to next: Health and Hospital System led by Charlene MacDonald, President & CEO of the Federation of American Hospitals.

And Medicaid and CHIP: State Innovation and Federal Priorities, led by Dr. Caprice Knapp, Principal Deputy for Medicaid and CHIP services at CMS, which is recapped below.

Medicaid and CHIP: State Innovation and Federal Priorities

Speaker: Caprice Knapp, Principal Deputy for Medicaid and CHIP Services at CMS

Delegates received a practical look at how Medicaid work requirements are moving from federal statute to state-level implementation. Framing the past year as one of the most active periods for Medicaid policy in recent memory, Knapp described a fast-moving environment in which states are preparing for new work requirements at the same time they are managing other major changes, including rural health funding obligations, six-month eligibility redeterminations, and October 1 eligibility changes affecting certain immigrant populations.

The discussion underscored that successful implementation will depend on the operational work already underway at the state level. While CMS is required to issue an interim final rule in June, states are already reconfiguring IT systems, working with vendors, training staff, and preparing new reporting processes. Knapp noted that expansion states will need to operationalize complex exemption categories, including medical frailty, caregiver status, and former foster youth, while also determining how to evaluate qualifying activities such as work, education, volunteering, and participation in state-sponsored jobs programs.

A central theme of the session was that effective execution of these changes will depend on coordination, communication, and administrative readiness. Knapp highlighted the risk of member confusion as work requirements intersect with six-month redeterminations, particularly for individuals whose renewals fall near implementation dates. She emphasized the importance of early outreach, supported by $200 million in federal grants, shared scripts and notices, and a national CMS campaign, to help states, plans, providers, and members navigate a transition that is both highly technical and deeply consequential for Medicaid operations.