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.