By: Carolyn Kowalyk

On March 3, policymakers, regulators, and industry leaders gathered in Washington, D.C. for the Better Medicare Alliance Health Executive Policy Summit to discuss the future of Medicare Advantage (MA) and broader Medicare policy. The conversations offered early signals about how the administration and policymakers are thinking about program integrity, payment accuracy, innovation, and the role of emerging technologies such as artificial intelligence (AI) in care delivery.

Discussions featuring:

• Chris Klomp, Deputy Administrator and Director of the Center for Medicare at the Centers for Medicare & Medicaid Services (CMS), as well as Chief Counselor at the Department of Health and Human Services (HHS)
• John Brooks, Deputy Administrator & Chief Policy and Regulatory Officer at CMS
• Tom Bednar, Healthsperien Senior Vice President and Counsel
• Stakeholders across the MA ecosystem

All highlighted a shared focus on sustaining Medicare Advantage while ensuring long term program integrity and beneficiary value.

Below are several key takeaways from the summit.

1. CMS Is Reframing the Debate on Medicare Advantage Coding Intensity

CMS leaders emphasized that payment policy changes reflected in the CY 2027 Advance Notice are intended to improve payment accuracy and ensure long term program sustainability.

During the discussion, John Brooks highlighted how methodological differences can significantly affect estimates of coding intensity between Medicare Advantage and traditional Medicare. Brooks and Chris Klomp referenced their recent 2026 Health Affairs Scholar analysis, which examined coding intensity using updated methodology and the transition to the V28 risk adjustment model.

Their analysis estimated approximately 1.5 to 2 percent uncorrected coding differences between MA and fee-for-service Medicare in 2022. Earlier estimates had suggested differences closer to 10 percent, including figures previously cited by the Medicare Payment Advisory Commission (MedPAC).

The discussion underscored the importance of grounding Medicare Advantage payment policy in transparent data and updated methodology as CMS continues refining risk adjustment and payment policies.

2. CMS Views Artificial Intelligence as a Major Opportunity With Guardrails

Artificial intelligence emerged as one of the most prominent themes of the summit. Chris Klomp described AI as potentially the most transformative technology in health care since the internet, with the potential to improve clinical decision making, reduce administrative burden, and extend physician capacity.

Klomp emphasized that AI should function as an “and,” not an “or,” meaning the technology should support clinicians rather than replace clinical decision making. He also stressed the importance of improving interoperability and empowering patients to maintain control over their health data as AI enabled tools expand across the health care system.

CMS leaders suggested that a principles based regulatory framework will likely guide AI adoption, balancing innovation with transparency, privacy protections, and appropriate safeguards.

3. Policymakers Are Focused on Outcomes and Long-Term Cost Management

Another clear theme from the discussion was the administration’s emphasis on improving outcomes while managing Medicare’s long term cost growth.

Klomp noted that poor quality care is often the most expensive care in the system. As a result, policymakers are increasingly looking toward models that reward improved outcomes rather than simply expanding services or administrative complexity.

Emerging technologies, including remote monitoring and AI enabled tools, may help support these goals by improving care coordination, identifying health risks earlier, and reducing administrative burdens on providers.

At the same time, CMS leaders emphasized that innovations must demonstrate measurable value, particularly as policymakers remain focused on ensuring Medicare’s long-term sustainability.

4. Public Sector Purchasers Highlight Unique Implications of MA Policy Changes

During a panel discussion on the Medicare Advantage ecosystem, Tom Bednar, Senior Vice President and Counsel at Healthsperien, highlighted the perspective of public sector purchasers participating in Employee Group Waiver Plans (EGWPs).

Bednar noted that public sector employers, including state and local governments, often rely heavily on Medicare Advantage to provide retiree coverage through multi-year contracts negotiated with plans. As a result, policy changes affecting MA payments can have significant downstream implications for employers and retirees who depend on these arrangements for long term coverage stability.

He emphasized the importance of predictability, transparency, and stakeholder engagement in Medicare Advantage policy updates. Purchasers and plans need sufficient time and information to assess how payment and risk adjustment changes will affect employer sponsored retiree coverage.

Concluding Thoughts

The Better Medicare Alliance Health Executive Policy Summit underscored that Medicare Advantage policy is entering a period of heightened scrutiny and strategic recalibration. Policymakers are balancing multiple priorities including maintaining beneficiary value, improving payment accuracy, promoting innovation, and safeguarding the long-term sustainability of the Medicare program.

Signals from CMS leadership suggest that the coming years will bring continued refinement of risk adjustment policies, increased attention to program integrity, and growing integration of technologies such as artificial intelligence into care delivery.