The Voice of David Sayen

David Sayen

About David Sayen

David Sayen is Senior Vice President of Client Relations at Gorman Health Group (GHG). In this role, David guides GHG clients in developing strategies to respond to rapidly changing federal program opportunities. David recently joined GHG after a distinguished career at the Centers for Medicare & Medicaid Services (CMS), most recently as the Administrator of the San Francisco Regional Office. Read more

What Does the Better Care Reconciliation Act Mean for Medicare Advantage Plans?

David Sayen

In a word, it’s trouble. Let me count the ways.

Top of mind is the Medicaid overhaul. Block Granting Medicaid has been the Holy Grail on the Republican side since Reagan. And why not: the Department of Health and Human Services (HHS) wants to download the risk to the states. Whether it is the per capita limits required by law or the optional Hobson’s Choice of the block grant for the entire population, it means one thing. Pain. States have to balance their budgets, unlike Uncle Sam who has that bottomless checkbook.

Read more

Leave a comment | Share | |

Global Warming Comes to Healthcare

David Sayen

On June 7, the Health Subcommittee of the House Ways and Means Committee heard and responded to testimony about Medicare Advantage (MA) and, in particular, how the program can be an instrument to advance care coordination and integration. The tenor of this hearing, combined with the recent unanimous passage of the bipartisan Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act by the Senate Finance Committee tells this reader ice isn’t just melting at the North Pole. There is a thaw in the chill that seemed to blanket parts of the healthcare industry since the election.

Read more

Leave a comment | Share | |

Risky Business. Are You Ready for MACRA?

David Sayen

It turns out Uncle Sam has a plan. He tried mightily to bend that stiff cost curve. He threw everything he had at it — fixed prices, automatic reductions, sophisticated relative value schemes. He could not do it. Turns out the pen (or mouse) is mightier than the sword because almost all of the Medicare benefit spend flows with the ink (or electrons) that is released by the physician’s hand. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is a game changer like prospective payment system (PPS).

Read more

Leave a comment | Share | |

Where is Healthcare Now? The Long March to Value-Based Care.

David Sayen

Read more

Leave a comment | Share | |

What’s Good for Obamacare Is Good for Medicare Advantage, and Vice Versa

David Sayen

I’m really excited to join Gorman Health Group (GHG) after more than 30 years at the Centers for Medicare & Medicaid Services (CMS), and I’m especially excited about the GHG Forum next week in Fort Worth. If you are sitting on the fence, now is a great time to jump in.  Make no mistake — we are at the tipping point where public finance at the federal level is quickly becoming the dominant driver of change in the whole system.  In 1966, Medicare was erected on the 30-year-old chassis that was the Blue Cross model.  Now the tables are turned: Obamacare is determining the shape of new market entrants, often in a push-pull with Medicare Advantage (MA), and nowhere is that more evident than in my adopted homeland of the People’s Republic of California.

Read more

Leave a comment | Share | |