What Must Change for Care to Be Better
Dr. Sachin Jain confronts structural problems of US health care.
He offers bold, clear-eyed ideas on how to build on what works, how to be honest about what’s broken—and how to jumpstart real change.
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Our Guest
Sachin Jain, MD, MBA CEO, SCAN Group and SCAN Health Plan
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.
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.
From 2015-2020, Dr. Jain was President and CEO of CareMore Health and Aspire Health. Dr. Jain led the diversification of CareMore, along with the acquisition and integration of Aspire Health.
Prior to joining CareMore, Dr. Jain was Chief Medical Information & Innovation Officer at Merck & Co. 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.
Episode Description
In this debut episode of Quality Talks With Peggy O’Kane, Founder and President of NCQA, Peggy is joined by Dr. Sachin Jain, CEO of SCAN Group and SCAN Health Plan, to explore a provocative question: Why isn’t health care better at getting better?
- Measuring—Not Missing—What Matters: Anxieties about access and affordability plague everyday people. But quality measurement’s focus is elsewhere. Is health care chasing the wrong metrics and missing the big picture?
- The Complacency Crisis: Sachin says the core issue is a reluctance to embrace real reform, noting the industry’s tendency to want improvement without being willing to change fundamental practices. He calls for a bolder approach.
- Rethinking Medicare & Medicare Advantage: Sachin challenges rosy view of traditional Medicare, and describes how a legal battle over a flawed Medicare Advantage star rating raised questions about how measuring quality affects care.
- Simplifying for Impact: Sachin proposes focusing on three or four areas, emphasizing patient experience, ease of access and basic care for common conditions. He urges cost transparency, simpler administrative processes and renewed competition.
Timestamps
(01:44) Inspired by Our Mentors in Health Care
(04:27) How Does Health Care Get Better?
(7:28) The Trap of Toxic Positivity
(11:34) Misplaced Nostalgia for Traditional Medicare
(18:05) The Stars Program Controversy
(22:13) Simplifying Health Care Measurement
