The Trust-First Model Transforming Medicaid Care w/ Dr. Toyin Ajayi & Mike Roaldi, Cityblock

Oct 2, 2026

57:08

Mental Health Health Equity Health Policy Primary Care

Episode Description

More than 70 million Americans are covered by Medicaid, and the people with the most complex needs, those juggling mental illness, housing insecurity, and chronic disease simultaneously, are the ones the traditional health care system is least equipped to reach.

Dr. Toyin Ajayi, Co-Founder and CEO, and Mike Roaldi, President of Cityblock Health, join host John Marchica to break down how a trust-first, interdisciplinary care model is producing measurable outcomes for over 100,000 Medicaid and dual-eligible members, and why value-based care may be more essential than ever as federal Medicaid policy undergoes some of its most significant changes in decades.

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🎙 ABOUT DR. TOYIN AJAYI
Dr. Toyin Ajayi is co-founder and CEO of Cityblock, a value-based healthcare provider serving Medicaid and dually eligible beneficiaries in underserved communities through integrated medical, behavioral health, and social care.

Previously, she served as Chief Medical Officer of Commonwealth Care Alliance, where she led clinical operations and care delivery innovation. Dr. Ajayi has been recognized by Modern Healthcare, STAT, and the Aspen Institute, and serves on the Board of Directors of Evolent Health and the Congressional Budget Office’s Panel of Health Advisers.

She earned degrees from Stanford University, the University of Cambridge, and King’s College London School of Medicine. Board certified in Family Medicine, she continues to practice primary care with a focus on patients with complex needs.

🎙 ABOUT MIKE ROALDI
Mike's career has spanned both legal and healthcare leadership roles, starting as a commercial litigator before joining UnitedHealth Group as National Vice President of Medicaid Policy and Product. He went on to serve as CEO of UnitedHealthcare Community Plan of Ohio, then as Chief Transformation Officer and President of Government Programs for Optum BH Solutions, and later as Chief Growth Officer and SVP of Growth and Product at UnitedHealth Community and State. In 2024, he joined Cityblock as President to help drive the company's next phase of growth.

Mike holds an undergraduate degree from the University of Notre Dame, a JD from Notre Dame Law School, and attended an Executive Education Program at Stanford Graduate School of Business.

🎙 ABOUT HEALTH CARE ROUNDS
Smart conversations with the people moving health care forward.

Health Care Rounds podcast brings together the leaders changing the future of health care and pharma, from how it's delivered and paid for, to where it's headed. Each episode goes deep on the decisions, innovations, and ideas reshaping the industry from the inside out. Hosted by John Marchica, CEO of Darwin Research Group and a longtime industry insider, every episode has one goal: leave you thinking differently than when you arrived.