Sachin Jain: I Propose Five Practical Reforms That Could Enhance the Medicare Advantage Program
Sachin Jain, President and CEO of SCAN Group and Health Plan and an Adjunct Professor of Medicine at Stanford University School of Medicine, shared a post on LinkedIn:
“In my latest Forbes column, I propose five practical reforms that could enhance the Medicare Advantage program, making it more transparent, equitable, and effective for the seniors and communities it serves:
1) Pilot Mult-Year Enrollment in Plans. No matter what anyone says about their value-based care results, value is ill-produced in healthcare in one year increments.
2) Standardize Plan Benefits. Plans are competing on nonsense and unsustainable benefits—often leading to a bait and switch for seniors. Standardizing benefits will improve plan competition and ensure every plan delivers consistent and meaningful value.
3) Reform broker incentives, rewarding year-round member support—not just sign-ups. Effectively deployed, brokers can be the missing glue we need t improve American healthcare.
4) Vary maximum broker commissions with star ratings. Star ratings should be an accelerant to sales. Fact: Today, a good number of brokers will tell you they don’t even know plan star ratings when they sell them.
5) Drive adoption of capitated payments to align provider incentives toward coordinated, value-based care. Health systems have been snookered by health plans who non-transparently push off the costs of supplemental benefits and other expenses. This explains why so many health systems complain of underpayments while MEDPAC claims Medicare Advantage overpayments. There is a better way.
Collectively, these reforms aim to improve the quality of the Medicare Advantage marketplace. As we collectively work toward building a more sustainable healthcare system, these are actionable steps that lawmakers, payers, providers, and advocates can take now.
I invite you to read the full article and share your thoughts: how might these recommendations reshape Medicare Advantage—and what additional levers are we missing?”
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