Future of Medicare: Innovating to advance health equity, expand access and improve outcomes

​As the largest purchaser of healthcare, Medicare is a powerful driver of care transformation across the United States.

At Forum 2022, Meena Seshamani, MD, PhD, Deputy Administrator and Director, Center for Medicare, Centers for Medicare & Medicaid Services (CMS) discussed the future of Medicare and the agency’s goals to advance health equity, expand access, drive innovation toward whole-person care, and improve outcomes.

In a fireside chat with Kelly Bliss, President of U.S. Group Health, Teladoc Health, Seshamani said Medicare is driving towards those goals by “putting the 63 million people who rely on our services at the center of everything that we do.”

Health Equity and Treating “People as People”

Policy changes during the pandemic made telehealth more accessible for Medicare beneficiaries. As policymakers and other leaders reflect on the lessons from the pandemic, Seshamani stressed it’s important to leverage telehealth innovations with an eye toward how such changes can advance health equity and drive high-quality, whole-person care.

Seshamani said Medicare continues to look for ways to expand access, especially with underserved communities in mind. In particular, virtual care and telehealth can drive innovation and move health equity forward by providing more access to care. These technologies can be used to enable better communication in a team-based approach, allowing the care team to treat “people as people” as opposed to an individual with a specific condition, she said.

Improving Health Outcomes with a Whole-person Approach

Seshamani spoke powerfully about the ways in which addressing patients’ unique needs and circumstances can enable better outcomes though whole-person care.

In her conversation with Bliss, she recalled caring for a patient with chronic obstructive pulmonary disease who was regularly readmitted to the hospital. When a community health worker was assigned to this patient, they realized the woman’s electricity was getting shut off, interfering with her nebulizer. Once the electricity issue was solved, the woman did not come back to the hospital and got healthier.

“People exist outside of that 15-, 30-minute office visit or outside a hospitalization,” Seshamani said. “And there are significant opportunities to expand our aperture of how we view people.”

Whole-person care also means an integrated approach that covers a person’s physical and mental health. In her previous role as a health executive, Seshamani observed that of the people with diabetes who were most readmitted to the hospital, about two-thirds also had a behavioral health diagnosis.

“You can give all the guidance about healthy eating, exercise, and insulin management, but if they cannot get out of bed in the morning because of their depression, you are not going to be able to really help them,” she said.

Policy Impact on Patients

During the conversation, Dr. Seshamani also shared an overview of the CMS Innovation Center, which supports the development and testing of innovative health care payment and service delivery models. Programs are tested and can be scaled for the broader Medicare program if successful. “The Innovation Center is the ice cutter, and Medicare is the aircraft carrier coming behind,” she said.

But for Seshamani, her experience caring for patients is the ultimate driver of innovation. “I am seeing the people that I have cared for, and how what we are doing now can help them,” she said. “My experience as a physician really does impact, at a very personal level, how I view what it means to keep the people that we serve at the center of everything that we do.”

​Don’t miss single moment from the event. Get more insights on the future of virtual care from Forum 2022.