Where Medicare Stands—And Where It’s Headed with Aetna’s Dr. Ali Khan

Dr. Ali Khan has spent his career at the intersection of
medicine, public policy, and value-based care. He’s also been at
the forefront of some of the country's most innovative care
delivery models—from Iora Health and CareMore to Oak Street
Health and now Aetna, where he serves as Chief Medical Officer of
Medicare at Aetna, a CVS Health company. In this episode, Keith
Figlioli sits down with Dr. Khan for a conversation about
Medicare’s future—and what it will take to make the promise of
better, more affordable healthcare a reality. 


A general internist by training, Dr. Khan’s path into healthcare
began with a deep curiosity about the broader systems shaping
people’s health. That curiosity took him from Harvard Kennedy
School to the exam room to health plans and startups focused on
reimagining the primary care experience for complex, underserved
populations. Throughout his career, he’s gravitated toward
organizations trying to solve public-sector problems with
private-sector solutions—building care models that prioritize
trust, access, and long-term outcomes. 


Now at the helm of a Medicare Advantage program serving 4.2
million members, Dr. Khan brings a unique vantage point. In this
conversation, he shares hard-earned lessons on care model design,
what payers and providers need from each other, and why Medicare
is at an inflection point. He makes a compelling case for a
renewed focus on the fundamentals—not just risk adjustment or
benefit design, but operational follow-through, last-mile care
coordination, and culturally grounded team-based models that
scale. 


Dr. Khan and Keith discuss: 


Building care models that hold up under pressure. From Iora
to Oak Street, Dr. Khan has seen firsthand that delivering better
outcomes at scale requires more than mission—it takes structural
rigor. He unpacks four key dimensions—cultural, clinical,
operational, and technological—and explains why lasting impact
depends on aligning all of them. Whether it's equipping care
teams to deliver in complex communities or building systems that
can flex and scale, success hinges on getting the foundation
right. 

Why affordability isn’t enough—and where Medicare Advantage
must go next. With over half of Medicare beneficiaries now
enrolled in MA plans, Dr. Khan argues it’s time to move beyond
the value prop of supplemental benefits and zero-dollar premiums.
The next chapter is about proving clinical excellence at scale.
That means prioritizing follow-through over features—removing
last-mile barriers, improving care coordination, and designing
experiences people actually trust.  

From transactional to transformative: the evolving role of
health plans. Plans have long relied on contractual structures to
drive change, but Dr. Khan believes that era is fading. To
deliver on the promise of value-based care, plans must shift from
passive administrators to proactive partners—investing in
infrastructure, surfacing actionable insights, and enabling
providers to succeed across Medicare, Medicaid, and commercial
populations alike. 

Where AI meets care delivery. Dr. Khan reflects on the
potential of AI to reduce clinical variation, improve medication
management, and drive better follow-up for patients—especially
those with chronic conditions. But he cautions that technology
alone won’t move the needle. To truly unlock AI’s value in
Medicare, plans and providers must embed it within human-centered
systems, coordinate care in real time, and ensure new tools
support—not replace—the relationships that matter most. 



As Dr. Khan notes, we’re entering a “put up or shut up” era for
Medicare Advantage, where scrutiny is high and proof points
matter. Yet within that pressure lies opportunity—particularly
for those willing to do the unglamorous work of identifying
barriers, building connective tissue, and supporting clinical
teams in the trenches.