Nothing lasts forever. That statement applies to the tenure of Medicaid directors just like it applies to every other aspect of our lives. This week, it applies directly to me because this coming Friday will be my last as New York State’s Medicaid director. As I prepare to depart my position, I can’t help but look back and contemplate all that I have learned and experienced. I have had the honor of having this position in New York for more than seven years. Before arriving in New York, I also had the pleasure to serve as Wisconsin’s Medicaid director. I am not sure what it says about me—between these two consecutive appointments, I am leaving office as the nation’s longest-serving Medicaid director.