The Medicare Advantage (MA) landscape is shifting dramatically. With over half of all Medicare beneficiaries now enrolled in MA plans, the program faces unprecedented scrutiny from lawmakers, regulators, and beneficiaries themselves.
During this 40-minute podcast, MA policy experts Carrie Graham and Neil Patil dissect the changing political and regulatory climate surrounding MA and offer crucial insights for health plans navigating these turbulent waters. They explore how the Trump administration is approaching MA reform through payment adjustments, increased oversight, and technological innovation.
Graham and Patil delve into hot-button issues driving the reform conversation: prior authorization practices that frustrate both providers and patients, marketing tactics that have drawn Department of Justice attention, and the accuracy of provider directories that directly impact beneficiary access to care. They discuss key bipartisan legislative proposals gaining traction, including the No UPCODE Act and the Improving Seniors' Timely Access to Care Act.
Listen now to understand how Medicare Advantage plans can rebuild trust with beneficiaries while preparing for the increased transparency and compliance requirements that lie ahead. The political winds are shifting—this episode provides the compass you need to navigate them successfully.
Want to learn more? Graham and Patil will speak at RISE West 2025, the Medicare Advantage senior leadership event of the year, August 25-27, at Paris Las Vegas. Also check out additional information from the Medicare Policy Initiative blog posts, publications, tools and resources, including a compendium of Medicare Advantage policies and a comparison tool of legislation that's been rumored to be included in a potential end-of-the-year legislative package (the Improving Seniors Access to Timely Care Act) and CMS regulations.
About the speakers
Carrie Graham, Ph.D., is a research professor and the director of the Medicare Policy Initiative at Georgetown University’s Center on Health Insurance Reform (CHIR), where she oversees a portfolio of policy analysis, research, and technical assistance for policymakers on Medicare Advantage and original Medicare.
Previously she was the director of aging and disability policy at the Center for Health Care Strategies. She also holds an adjunct professor appointment at the University of California, San Francisco, Institute for Health and Aging.
Dr. Graham has been working in the field of aging research, health policy, and evaluation research for over 25 years, including evaluating California’s Dual Financial Alignment Initiative and other efforts to expand managed care delivery systems for older adults and people with disabilities. In 2018-2019 she worked as a Health and Aging Policy Fellow in the U.S. House of Representatives, Committee on Ways and Means on Medicare oversight and legislation for post- acute care, surprise billing, and price negotiations for Part D prescription drugs. In 2020 she acted as consultant to California in the development of the state’s Master Plan for Aging; and subsequently provided technical assistance for over 20 states developing their own multisector plans for aging. Dr. Graham holds a Doctorate in Medical Sociology from UCSF and a Master’s Degree in Gerontological Studies from the Scripps Gerontology Center at Miami University. She obtained her Bachelor’s degree from University of California, San Diego in Sociology and African Studies.
Neil Patil, MPP, is a senior fellow and the policy director at the Medicare Policy Initiative at CHIR, where he conducts policy analysis and provides technical assistance to policymakers on Medicare Advantage issues.
Prior to joining CHIR, he was a senior analyst at the Centers for Medicare & Medicaid Services Office of Legislation, where he provided technical assistance to Congress on issues related to Medicare Advantage and the Medicare Drug Price Negotiation Program. In
this role, he served as the lead analyst on Medicare Advantage issues. He was also instrumental in supporting the passage and early implementation of Medicare drug pricing policies included in the Inflation Reduction Act.Patil has also served as the legislative assistant/clerk in the U.S. House of Representatives, Committee on Ways and Means and as a policy associate for the U.S. Senate Committee on Finance. In these roles, his work has focused on issues related to Medicare reform, drug pricing, nursing home oversight, health equity, as well as other Medicare issues. He holds a Master of Public Policy from Georgetown University’s McCourt School of Public Policy and a Bachelor of Arts in Economics from Xavier University.