Medicaid Industry Who’s Who Series: Rosemarie Day

Medicaid Who’s Who: Rosemarie Day – Founder and President of Day Health Strategies

  1.  Which segment of the industry are you currently involved?

A: Day Health Strategies provides experience-based, cost-effective consulting services to private and public organizations that are focusing on strategic opportunities stemming from health reform, health sector transformation, and the emerging benefits marketplace.

Currently, my firm is working on implementing one of the Medicaid Accountable Care Organizations in Massachusetts. This project has included assisting in the creation of a governance structure, developing the model of care, completing regulatory compliance submissions, and assisting with investment planning and project management. We also recently worked with Rhode Island’s Executive Office of Health and Human Services to take a look at some long-standing issues of resource scarcity and flawed organizational design and develop new approaches and modern organizational design that would better serve the needs of the Secretariat and Medicaid.

2. How many years have you been in the Medicaid industry?

A: I spent most of my career working in anti-poverty and health programs. I have been working in the Medicaid and health insurance exchange space for 15 years. This includes working as the Chief Operating Officer of the Massachusetts’s Medicaid program, as the founding Deputy Director & Chief Operating Officer of the Health Connector in Massachusetts, and through my consulting work with my firm Day Health Strategies.

 3.  What is your focus/passion? (Industry related or not)

A: Two of my biggest passions are reducing inequality in the USA and making the healthcare system more patient-centered and affordable.

 4.  What is the top item on your “bucket list?”

A: The top item on my bucket list is to continue to travel around the world, seeing as many countries as possible.

 5.  What do you enjoy doing most with your personal time?

A: In my personal time, I really enjoy reading, exercising (especially if it involves music, dance is best!), and traveling.

 6. Who is your favorite historical figure and why? 

A: Elizabeth Cady Stanton is my favorite historical figure because she was a feminist way ahead of her time who managed to be both an advocate and mother to 7 children. She was able to go back and forth between advocate and family duties in a time before multi-tasking was as prevalent as it is now. I really respect someone who could juggle it all, especially in that era. I also feel that she did not get enough credit for getting women the right to vote.

7.  What is your favorite junk food?

AI love BBQ chips and Dr. Pepper!

 8.  Of what accomplishment are you most proud?

A: I am most proud of establishing the Massachusetts Health Connector. It was very challenging and took a lot of work, but it was extremely rewarding to see that the Connector’s success led it to become the model for the Affordable Care Act.

 9. For what one thing do you wish you could get a mulligan?

A: Generally, I feel like I always learn something from the things in my life that went poorly. But I will say that I was raised to be exceedingly polite and I should have been a little more outspoken earlier.

 10. What are the top 1-3 issues that you think will be important in Medicaid during the next 6 months? 


  • Waivers will be something to watch over the next 6 months. Depending on the agendas of the state, the state waivers vary greatly. Many conservative states have pending waivers that would limit eligibility or add additional requirements for eligibility. Many other states are in the process of implementing their 1115 waivers that were approved before the Trump administration. Another aspect of state waivers to track is the idea of the super-waiver that would combine 1332 with 1115 waivers.
  • Medicaid Managed Care has to prove its value. With budget pressures, managed care can’t just be another layer of administrative overhead. Budget pressures will persist and there will be a continued search to do more with less. One way that MCOs can think about adding value is by partnering with provider organizations to work together and align their incentives. This partnership is being done in many states through Medicaid Accountable Care Organizations (ACOs). Because my company is based in Massachusetts, we are keeping an eye on the Massachusetts Medicaid ACO program, which just launched March 1st, 2018, and looking at how the lessons learned can be applied to other states.
  • Medicaid has always required strong leaders but now leaders need to be able to think across silos and outside of the traditional purview of Medicaid. This is because of the complexity of healthcare and the many lines that are blurring, including the merging of insurers and providers, and the changing market of subsidized care (exchanges and efforts to expand or contract Medicaid populations). Governors need a strategic health advisor, which could potentially be encompassed in the role of the Medicaid Director.