The Big Healthcare Reset
"There's been a degree of toxic positivity in US healthcare, where coding companies call themselves value-based care companies," says Dr. Sachin Jain, CEO of SCAN Health Plan. In this candid conversation about healthcare's need for radical change, Dr. Jain challenges industry orthodoxy and calls for a leadership revolution. From Medicare Advantage turbulence to the failures of healthcare consolidation, he offers an insider's view of what needs to change.
We cover:
🔄 Why healthcare needs to move beyond "toxic positivity" and incremental improvements toward real transformation
⏰ The fundamental flaw in value-based care: measuring outcomes in one-year increments when real health improvements take decades
💰 Medicare Advantage's current challenges, including benefit cuts, market exits, and controversial star ratings
🏥 Why healthcare consolidation has failed to deliver better outcomes and may be driving clinician burnout
🏠 How SCAN's "12 angry seniors" sparked a movement to help people age at home, and why that mission remains relevant today
⚡ The need for a new generation of healthcare leaders willing to think big instead of being trained to be incrementalists
🔑 His advice for the new administration: rethink CMS as a competition regulator rather than just a claims processor, and make the star rating system more robust and statistically significant
About our guest:
Sachin H. Jain, MD, MBA is CEO of SCAN Group and SCAN Health Plan, where he is charged with leading the organization’s growth, diversification, and emerging efforts to reduce healthcare disparities. SCAN’s revenues top $4.8B and the organization serves more than 300,000 members.
Under Dr. Jain’s leadership, SCAN was rated number one in customer satisfaction among Medicare Advantage plans in California by J.D. Power; received 4.5 STAR ratings an unprecedented six years in a row; launched a range of new products—including Affirm, the first ever LGBTQ+ health plan product and Inspired, the first health plan designed specifically for women; and expanded its operations into Arizona, Nevada, Texas and New Mexico. SCAN has also launched four subsidiary medical groups intended to support seniors through the full range of inflection points in the aging process. In a little over three years, SCAN’s total revenues have grown by more than $1.5B.
From 2015-2020, Dr. Jain was President and CEO of CareMore Health and Aspire Health, innovative care delivery systems with more than $1.6B in revenues, which serve 200,000 Medicare and Medicaid patients in 32 states. Dr. Jain led the diversification of CareMore, along with the acquisition and integration of Aspire Health. At CareMore, he pioneered and scaled the first scaled clinical program in the world focused on social isolation.
Prior to joining CareMore, Dr. Jain was Chief Medical Information & Innovation Officer at Merck & Co. He contemporaneously served as an attending physician at the Boston VA-Boston Medical Center and as a member of the faculties at Harvard Medical School and Harvard Business School. From 2009-2011, Dr. Jain worked in leadership roles at the US Department of Health and Human Services, where he was Senior Advisor to the Administrator of the Centers for Medicare & Medicaid Services (CMS). Dr. Jain was the first Acting Deputy Director for policy and programs at the Center for Medicare and Medicaid Innovation (CMMI). He also served as Special Assistant to the National Coordinator for Health Information Technology.
Dr. Jain graduated magna cum laude from Harvard College with a BA in government and earned his MD from Harvard Medical School and MBA from Harvard Business School. He trained in medicine at the Brigham and Women's Hospital and earned his board certification from the American Board of Internal Medicine. He is an adjunct Professor of Medicine at the Stanford University School of Medicine and a practicing Academic Hospitalist with the U.S. Department of Veterans Affairs. He serves on the boards of America's Health Insurance Plans (AHIP), Omada Health, Advantage Healthcare Services, and The Paul & Daisy Soros Fellowships for New Americans..
A respected thought leader in healthcare, Dr. Jain’s columns for Forbes are widely read by healthcare leaders. He has been recognized by Modern Healthcare as one of the “100 Most Influential People in US Healthcare,” by the Boston VA Medical Center for excellence in clinical care with the “Golden Heart Award,” and by Brigham and Women’s Hospital for excellence in mentorship. LinkedIn named him its top voice for healthcare industry-related content.
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