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

Medicare Modernization Act 2.0? CMS Finalizes Policy Changes and Updates for MA and Part D

David Sayen

The policy changes and updates made by the Centers for Medicare & Medicaid Services (CMS) for Medicare Advantage and the Prescription Drug Benefit Program finalized on April 2, 2018 are a step in the right direction.

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The Effects of Rising Healthcare Costs in the U.S.

David Sayen

nyt - david sayenWednesday’s New York Times includes a piece about the impact of health and the cost of care on financial health. Health insurance was created to cushion these shocks, but it’s not working anymore. Why?

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The New Medicare Advantage Supplemental Benefits Policy Is the Biggest News in Years

David Sayen

The draft 2019 Call Letter for Medicare Advantage (MA) included new flexibility for plans around supplemental benefits. It was codified in the recent budget resolution to keep the government open and represents the biggest news for the industry in years. It offers a whole new toolbox for plans to address social determinants of health.

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Feeling the Burn on Medicare

David Sayen

“We don’t have to invent Medicare, we have it…it is a popular, effective program. Unfortunately, it is only applicable to people 65 or over. So the simple answer is…Medicare should be available to all of us.”

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CMS Expands MA Value-Based Insurance Design Model For 2019

David Sayen

No, the Reagan administration hasn’t come back, but things are looking up in our corner of the world. The Centers for Medicare & Medicaid Services (CMS) is a big ship, and it takes awhile to turn it around after a presidential transition. It is becoming clear the direction will continue to be towards value, but the path is shifting. The government needs to reduce the spend on healthcare, and reducing benefits and restricting eligibility aren’t going to fly on the Medicare side, so we have to get more bang for the buck.

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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.

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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.

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