Sachin Jain: Changes we might see to Medicare Advantage in the incoming Trump administration
Sachin Jain, President and CEO of SCAN Group, shared a post on LinkedIn:
“Changes we might see to Medicare Advantage in the incoming Trump administration:
1) Medicare Advantage For All? We know that the Trump Administration favors private administration of our publicly funded program for older adults. Could a Republican Congress and Senate and President lead to a total reboot of the Medicare program that more fully leverages the private sector.
With more than 50% of seniors enrolled in the program today – It’s certainly possible.
2) Slowed or Delayed Implementation of V28: Next year is the last year of the phase in of the new coding model. Could the administration slow its implementation or roll it back in some way? Or might it work on a new risk-adjustment model like the one proposed by Mark McClellan and colleagues at Duke University?
3) A Stars Refocus on Member Satisfaction: the Trump administration previously weighed member satisfaction more strongly in the Centers for Medicare and Medicaid Services star ratings equation. The Biden administration rolled it back. This is an area of potential see-sawing of relative importance of member satisfaction.
4) De-Prioritization of Health Equity: the Biden administration included a health equity index in star ratings and made health equity a major focus of CMS’s programs and policies. It’s questionable whether this focus will remain with a new administration.
5) A Roll-Back on FMO Regulations: the Biden administration implemented new regulations that are being challenge in federal court on payments to Medicare field marketing organizations. Could a Trump administration suspend these changes?
Time will tell on the specific nature of changes. What I can say – with confidence – is that the next four years will be a time of a lot of dynamic change in the Medicare Advantage program.”
More posts featuring Sachin Jain.
Sachin H. Jain is the President and CEO of SCAN Group and Health Plan and an Adjunct Professor of Medicine at Stanford University School of Medicine. He also serves as a Board Member at The Paul and Daisy Soros Fellowships for New Americans, an Academic Hospitalist (WOC) at the U.S. Department of Veterans Affairs, and a Board Member at America’s Health Insurance Plans (AHIP). He is also a board member of Omada Health.
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