Bay Area

October 15, 2024

Preparing for Post-Election Healthcare Changes

With less than a month to the Election, one thing is sure: come January 20th, Joe Biden won’t be sitting in the Oval Office. But whether Harris or Trump is, could make a Big Difference for healthcare.

Medicare Advantage plans now cover 54% of Medicare beneficiaries. And many of the MA plans are hurting. Already, the two largest plans, Humana and United-Healthcare, were “Star-downgraded.“ So now, with lower capitation fees, plans will likely look to cut patients’ supplemental benefits and providers’ reimbursements.

We’ll open our Members Discussion with what you and your healthcare organization are seeing in your Post-Election Crystal Ball – and how you’re preparing for it. And, we’ll look to hear What Else Is Keeping You Up Nights?

Then, we’re honored to have two government healthcare programs experts: John Gorman, currently chairman of Nightingale Partners, launched his storied career from HCFA’s (now CMS’s) Office of Managed Care, and David Sayen, president of Alameda Health System Board and former CMS Region 9 Administrator, who have witnessed how the nation’s CEO can dramatically change the government’s oversight and payment for healthcare. Or not. Based on their impressive careers in the government and advising clients how best to interact with it, you won’t want to miss this session!

John Gorman founded and Chairs Nightingale Partners LLC, the first venture fund to invest in early-stage companies in the social determinants of health ecosystem. Earlier, he was Chair and CEO of Gorman Health Group, the leading consulting practice specialized in government health programs. Today, he’s on the Boards of Henry Ford Health System’s Health Alliance Plan, Edenbridge Health, and RoundTrip. Earlier, he was appointed by President Clinton as the first Assistant to the Director of HCFA (now CMS) Office of Managed Care, where he provided day-to-day management, and served as the external liaison for the Medicare and Medicaid managed care programs. He began his career in Washington as Press Secretary and Staff Director for Representative John Conyers, Jr. (D-MI), then-Chairman of the Government Operations Committee. During the 1993 debate on national health care reform, he was chief lobbyist for FQHCs.

David Sayen is President of the Board of Trustees of Alameda Health System, and a visionary leader with expertise in government health programs, particularly Medicare and Medicaid, based on his 30+ years at CMS, most recently as the San Francisco Regional Administrator. He also advises investors and clients on government contracting, compliance, business development and strategy, and works in an advisory capacity with businesses in the health technology and IT services sector in Silicon Valley and around the country. He’s an expert on the provisions of the ACA, and more recent Bipartisan Budget Agreement’s health provisions, having worked on the development of the Center for Medicare and Medicaid Innovation at CMS. He also was member of the Federal Senior Executive Service and has extensive experience developing and executing campaigns related to public health, health insurance and access to health services.