Spotlight On: Matthew Wolfe, Managing Shareholder, Baker Donelson – Raleigh

Key points:

• • Medicaid policy, workforce shortages, and AI are reshaping healthcare.
• • The Triangle’s universities and healthcare ecosystem continue to drive growth and innovation.
• • Care-at-home models, digital health, and regulatory adaptation are key opportunities ahead.

June 2026 — Invest: spoke with Matthew Wolfe, managing shareholder of Baker Donelson’s Raleigh office, about healthcare regulation, innovation, and the Triangle’s growth trajectory. “One of the things that is interesting, and often frustrating, about healthcare is that things that make business sense are rarely permissible from a healthcare compliance perspective,” Wolfe said.

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What changes over the past year have most impacted the healthcare, legal, and regulatory environment, and how are they shaping your priorities in the area?

Three things are really helping to shape the environment in the Triangle, particularly in terms of healthcare, legal, and regulatory issues.

The first factor is what is happening in Washington, D.C., and its impact here in Raleigh. Healthcare is a significant portion of state and federal government spending, and there is a lot of interest in making sure Medicare and Medicaid programs are run with integrity. What is happening with the new administration in D.C., and how the Centers for Medicare and Medicaid Services are signaling to the market how they want to shape healthcare, is having a lot of ripple effects locally.

The state’s General Assembly is almost always focused on the budget. A major portion of the budget is making sure we have sufficient funds for our Medicaid program, which was expanded a few years ago and has added over 600,000 North Carolinians to its rolls. Medicaid is going to be a critical component of how North Carolinians continue to access world-class healthcare and how providers are able to sustainably meet those needs.

The second factor is the workforce. We are fortunate to be in a growing area. Depending on which part of the Triangle you are talking about, it is aging faster in some places, while in others it is becoming younger as we see recent college graduates and others moving into the area. People’s utilization of healthcare services is not uniform across their lifespan. In places that are aging with the retirement of the baby boom generation, we are seeing an increase in the need for services. There is no corresponding resupply of qualified workers, particularly in the direct care workforce.

Every healthcare provider, whether it is a large health system, hospital, nursing home, home care agency, home health provider, behavioral health facility, or community provider, is grappling with how to attract and retain people committed to healthcare for the long term. That is going to be an existential crisis for the next two decades, just looking at the demographics.

The third factor is the role of AI and other technologies. They are a great opportunity for healthcare to evolve and pursue the Quadruple Aim. For many established providers, AI is also a risk. It creates regulatory risks and potential competition, including from places that would not traditionally be seen as competitors.

How is this impacting how healthcare providers navigate compliance, reimbursement, and operational challenges?

Every healthcare provider, regardless of where they are in the market, the services they provide, or their size and scale, is not sitting still. Everybody is innovating. Innovation is not just a luxury; it is a necessity.

Innovation looks different depending on who it is coming from, but much of it involves integration and forming strategic alliances. It also means exploring ways to have more skin in the game, especially with new payor models. Accountable care organizations have been around for a long time, but there are many things happening at the federal level that are moving providers away from a fee-for-service, volume-based approach and toward paying for quality and outcomes.

We are going to continue to see an embrace of telehealth, and not only telehealth, but also really moving healthcare decision-making and healthcare data collection from a hospital bed or suite into people’s homes. That includes wearable technology and implantable devices, but it also includes AI as a mechanism to take all this rich data we now have and operationalize it so people can make changes in how they take care of themselves and live healthy lives.

What makes the Research Triangle attractive for business growth, both from a firm perspective and for your clients?

We are anchored by three world-class research universities in NC State, UNC, and Duke. In addition, we have other great colleges and universities, including North Carolina Central University, Elon, and Campbell. We are fortunate to have such an educated workforce.

The Triangle is becoming a destination. It is a place people go not only to earn a degree, but also to establish their profession.

Within those colleges and universities, we have two academic medical centers in UNC and Duke. There are not many places in the world where you can have access to that kind of tertiary and quaternary care just down the road. I often talk with colleagues in other places who are trying to figure out how to get to the Research Triangle to see a specialist or someone who is the global leader in a rare disease or particular procedure.

With those two academic medical centers, an educated workforce, and a growing population, the Research Triangle has long been attractive to investors. One thing that has begun to take shape is the integration of different parts of the ecosystem. Research Triangle Park has more than 300 companies and 55,000 workers. It has always been a hub of innovation, particularly for pharmaceuticals and life sciences.

Now you are starting to see a melding of things that may have once seemed separate: life sciences, healthcare, pharmaceuticals, and IT. If you have an innovative idea to bend the cost curve in healthcare and you are thinking about where to headquarter your business, the Triangle offers access to a robust healthcare ecosystem, a great workforce, and a relatively reasonable cost of living compared with other places we compete with for inbound companies.

It is also a great place to live: a few hours from the mountains, a few hours from the beach, and lots of cultural amenities. I am biased, but it is a hard place to beat in terms of all those components.

What role does legal and advisory support play in helping organizations adapt to new technologies and changing operating models?

One of the things that is interesting and often frustrating about healthcare is that things that make business sense are rarely permissible from a healthcare compliance perspective. That is largely because we have state and federal regulatory structures that were developed in a different time in terms of where people received care, how that care was provided, who provided it, and how it was paid for.

There have been efforts at the federal and state levels to update some of that legal and regulatory environment, but we are largely still dealing with a regulatory structure that is over 50 years old. Then we are trying to take novel, innovative ideas and fit them into that structure.

When I encounter a new client or a client trying to do something innovative, my job is not to say, “no, you cannot do that.” It is about figuring out how we can take the idea and transform it into something that will pass regulatory scrutiny. Often, that involves dialogue with regulators and shaping the message around why the idea is a good thing, and why the concerns that often animate those legal and regulatory protections are not at play with the innovative product, service, or model of care the client is pursuing.

One thing that positions us is that we are always trying to figure out a way to realize the client’s business objective. Sometimes that means saying, “you cannot do it this way, but you can do it another way,” and trying to get them to the same waterfall while taking a path that is less thorny.

What are your top priorities for supporting clients in the region, and what key risks and opportunities are shaping healthcare over the next few years?

As with healthcare itself, we are going to continue to see growth and consolidation. We are trying to keep up our team to meet the needs of our growing roster of healthcare clients.

In the same way every healthcare provider talks about integrated care, we are trying to make sure the services we provide as attorneys are integrated. Clients should not need to call eight different law firms to work on one project because one firm does tax advice, another does regulatory advice, and a third does real estate work. We want to make sure we have a team that can meet clients’ needs, regardless of the specific needs on a given project.

We are also invested in staying on the leading edge of changes in the legal and regulatory environment, the market, and technology. We are investing in AI and making sure it meets the needs of our clients, while continuing to provide cost-effective, high-value legal services.

What additional healthcare trends should leaders be watching?

One thing I would double down on is the importance of care at home. Coming out of the pandemic, that went from a nice thing to have to becoming the center of most people’s care experience.

We are going to continue to see not just acute care hospital at home, but also digital health that allows people to access care independent of where they are. Businesses focused on that segment, and trying to connect it so patients can have an integrated care experience from the time they wake up not feeling well to the time they go to bed that night, will see more investment and focus.

I think we are also going to see a lot more focus on speeding up that timeline, because the patient is becoming a lot less patient about how quickly they should get answers. We have had the World Wide Web and “Dr. Google” for a while, and now we have generative AI models. People are uploading lab reports and imaging, and asking what is happening and what they need to do.

For incumbent providers, or those that want to expand their role in the space, they need to figure out how to compete with people’s insistence on getting answers quickly, while making sure the answers are not just quick, but also accurate and helpful to the individual patient.

One thing AI has not figured out yet, and we see this in the legal profession as well, is humility, or how to say, “I do not know,” or “I am not sure.” The models are designed to give you an answer, and the most likely answer, but that does not mean it is the right answer. Sometimes the answer is not clear.

In the law, there is a lot of uncertainty. There are fact patterns that have not been clearly resolved, which is why the courts are still full of cases and attorneys. Sometimes the answer is that it is not clear, or that there is a chance of one outcome or another. The same is true in terms of risk and uncertainty in healthcare. I do not think AI tools are particularly well-suited to be comfortable in the gray.

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