I just returned from the National Association of State Medicaid Directors Annual Conference (NASMD). But when I say, “I’m back,” that’s not exactly what I mean. Many people at the conference expressed disappointment at not receiving enews from me for the past several months. You’ve been wondering what I’ve been up to.

I decided to take a job. Yes, JOB. There are many reasons for my decision, but here’s the one that keeps me inspired. I want to make a positive impact. Yes, idealistic as always, I’m still trying to find ways to make the world a better place. No, I did not join the Peace Corps.

I still want to stop healthcare fraud. I have not stopped working on that. I’ve expanded my scope of work. Preventing fraud in a healthcare system that is on a disaster course seems futile at times. Is comparing it to fixing an oil leak on the Titanic too cynical? Perhaps.

Since early February 2005, I’ve been working on changing the course of parts of the healthcare industry. I’m working for FourThought Group, a thought leader in the healthcare industry. We have a vision for helping Medicaid transform into part of an effective, sustainable system for improving health and wellness. While this may sound idealistic (there’s that word again) to some, striving towards this goal is the only way to avoid sinking under the growing burden of rising medical costs. My impression from the NASMD Conference is that many state and federal leaders are coming to the same conclusion. Dramatic change is coming—the question is what kind.