The Surgeon & Economics PhD Leading Medicare: Dr. Meena Seshamani

Dr. Meena Seshamani is responsible for the health care coverage of more than 63 million Americans and nearly one in every five healthcare dollars spent in the U.S. With the ultimate goal of keeping the people who rely on Medicare at the center of every decision, her role as the director of  the Center for Medicare at the Centers for Medicare & Medicaid Services (CMS) requires her to balance the personal side of healthcare with the complexities of the healthcare system at large. And she has a rare combination of qualifications that give her a profound expertise with both.

As an ear, nose and throat surgeon, Dr. Seshamani has worked at leading health systems delivering care at the patient bedside and serving in senior executive leadership roles. As a PhD in healthcare economics, she has decades of healthcare policy experience. She recently served on the leadership of the Biden Administration’s transition team at the Department of Health and Human Services and was previously director of the Office of Health Reform where she drove strategy and led implementation of the Affordable Care Act across the department.

This diverse background as a health care executive, health economist, physician and health policy expert gives her a unique perspective on how health policy impacts the real lives of patients.

In this episode of Healthcare is Hard, Dr. Seshamani spoke to Keith Figlioli about her expansive role and her focus on the key pillars at Medicare: advancing health equity, driving innovation in healthcare, maintaining good fiscal stewardship and delivering high-quality, person-centered care. Their conversation covers several topics including:

• A day in the life of CMS. While every day is different, one recurring theme Dr. Seshamani discusses throughout the interview is the importance of listening to patients, staff, partners and others. She says her education and experiences have given her the humility to understand that no one person knows everything and that listening to all stakeholders is a critical component to realizing the power Medicare has to positively impact healthcare in America.
• Pieces of the Medicare puzzle. Medicare Advantage plans continue to grow in popularity and now account for more than 40% of Medicare enrollees. And while that means more people are transitioning away from traditional Medicare, Dr. Seshamani shares her thoughts about the continued importance of every piece of the Medicare program. The main objective is providing people with options so they can find the solution that works best for them which in turn, drives the system towards achieving the vision of greater health equity.
• Helping people navigate Medicare. With so many options in the Medicare program, especially with the proliferation of Medicare Advantage, it creates challenges to help seniors navigate them all. But Dr, Seshamani looks at that challenge and sees it as an opportunity. She talks about ways to provide people with the data and information they need to make decisions and the changes CMS is making to the Plan Finder to make that process easier. She also talks about adding additional oversight over third-party marketing for Medicare Advantage based on direct feedback she received about the confusion it can cause for seniors nationwide.

To hear Meena and Keith talk about these topics and more, listen to this episode of Healthcare is Hard: A Podcast for Insiders.