Time For Medicare Advantage Leaders—Including Me—To Eat Our Own Cooking

Posted by Sachin H. Jain, Contributor | 21 hours ago | /healthcare, /innovation, Business, Healthcare, Innovation, pharma, standard | Views: 17


In every industry, the best leaders live the experience of the customer. Car executives drive their own vehicles. Airline leaders occasionally fly coach. Restauranteurs eat from their own kitchen.

But in healthcare—and specifically in Medicare Advantage (MA), which now serves more than 30 million Americans—the leaders designing these plans rarely, if ever, use them themselves. This disconnect breeds an empathy gap between decision-makers and the seniors whose lives and well-being depend on these products.

It’s time to close that gap.

As Dr. Mehmet Oz turns 65 and qualifies for Medicare, he is in a unique position to lead the charge in fixing this blind spot. But I’m not letting myself off the hook either. As a current CEO of company that sells Medicare Advantage plans, I am proposing a standard that would apply to me and every other leader in this space: if you run a Medicare Advantage plan—or sit on its executive team that runs these plans—you should be required to enroll in that plan. No carve-outs. No executive-only exemptions. No platinum side-door coverage.

For those of us under 65, the proposal would also require a structural change: expanding Medicare eligibility to allow MA plan executives early, voluntary enrollment in their own plans. We should not be allowed to claim ignorance or detachment simply because of our age.

I want to be clear: if such an early-enrollment window existed, I would enroll myself. I should have to live under the same benefit design, customer service, and network constraints as every other member. Leaders like me—and my peers across the industry—must eat our own cooking.

A Modest But Necessary Reform

The proposal is simple but powerful:

1. All managed care CEOs and executive teams must enroll in their own MA plan.

2. Congress and CMS should create a new category of Medicare eligibility that allows executives under 65 to voluntarily enroll in their own MA plans in a “test user” capacity. This is the only way for leadership to truly understand the member experience.

3. No waivers, no special coverage allowances. The goal is to force leadership to live the true plan reality: the prior authorizations, the formularies, the network restrictions, the call centers, the appeals processes.

Why It Matters—for Me, and for the Industry

I don’t make this proposal lightly—because it would apply to me, too. If this became law or industry standard tomorrow, I would sign up. And I believe most honest leaders would welcome the clarity and accountability it would bring.

Here’s why it matters:

– Operational Truth: You only truly understand the friction points—customer service delays, billing errors, prescription denials—if you live them yourself.

– Accountability: Plan leaders would no longer tolerate broken systems they themselves have to endure.

– Culture Change: A company where the C-suite shares the same risks and frustrations as members cannot help but become more consumer-focused.

– Public Trust: Medicare Advantage is under increasing scrutiny from policymakers and the public. This move would send a clear, ethical signal: we stand behind what we sell.

– Policy Innovation: The best ideas for simplifying prior authorization, improving networks, and reducing out-of-pocket costs would come not from distant consultants—but from firsthand experience.

No More “Not For Me” Products

Too much of healthcare is designed by people who never have to use it. Too many decisions are made in corporate conference rooms far removed from the lived experience of real patients. If Medicare Advantage is the future of healthcare for seniors—as so many believe—its architects must also live that future.

That includes Dr. Oz. That includes every MA CEO. And that includes me.

It’s time for all of us to eat our own cooking.



Forbes

Leave a Reply

Your email address will not be published. Required fields are marked *