In this episode, Rachel Spilo talks with Scott about what that turnaround actually took, why sprinting works as a crisis strategy and fails as an operating model, and the work he picked up after a retirement that did not stick.

Scott is the founder and CEO of Serrano Advisors, formed in 2023, now supporting close to half of California's counties on justice-involved reentry: county jails, probation departments, county behavioral health agencies, and managed care plans. He walks through the decades-old inmate exclusion that kept Medicaid and correctional health on separate tracks, what the 1115 demonstration waiver opened up, and the two lessons other states keep learning the hard way.

Also in this one: where AI genuinely helps versus where the hype falls apart, what 30 icons on a desktop tells you about your operations, and a Final Five that lands on koala bears, a winery, and beekeeping.

CHAPTERS 0:00 Welcome and who is Scott Coffin 0:45 Walking into a plan under state conservatorship 1:26 The hardest realities: quality scores and claims backlogs 2:23 What outsiders misunderstand about public health plans 4:12 Growing up on the border, and starting out in claims 5:30 What pulled him toward leadership 6:49 Sprinting is a crisis strategy, not an operating model 8:13 The decisions that stabilized the organization 10:02 Out six months early, and handing off to Matt Woodruff 10:37 The retirement that did not stick 11:02 Why justice-involved reentry 12:29 Building Serrano Advisors 13:57 Why the release window decides outcomes 16:19 Social determinants as the anchor of reentry 19:14 The inmate exclusion, and what the waiver changed 20:42 Lessons other states should take now 23:41 AI: genuinely useful versus overhyped 26:02 What leaders should watch for when adopting new tools 27:00 Advice for executives taking on a turnaround 27:54 The payer leaders he admires 28:49 Advice for anyone considering the entrepreneurial path 30:57 What's next 31:31 The Inspired and Unscripted Final Five 34:11 Bees, third graders, and a proper goodbye

ABOUT THE GUEST Scott Coffin is the founder and CEO of Serrano Advisors, which supports county agencies and health plans on justice-involved reentry and coordinated care. He served as CEO of Alameda Alliance for Health from 2015 to 2023, leading the plan out of state conservatorship and into local control. Before that he was Executive Director for Anthem Blue Cross, overseeing Medi-Cal across 18 Northern California counties. He is a graduate of the Tuck School of Business at Dartmouth.

ABOUT THE SHOW Inspired and Unfiltered is hosted by Rachel Spilo, featuring candid, no-spin conversations with the people shaping healthcare, business, and leadership. 

Music licensed through Soundstripe. License code: 6RZ28WQYEBRJKZGX

#healthcare #medicaid #healthcareleadership