Marwood, the Association for Community Health Plans, and MAST Health Policy Solutions discussed the Medicare Advantage 2025 Advance Notice, reactions from the industry and policymakers and what it all means for health plans. The panel provided analysis on the impact of these changes, what health plans need to know moving ahead, and policy recommendations to further improve the program
Mr. Mercer leads Marwood’s healthcare services and managed care practices. Prior to joining the Marwood Group, Mr. Mercer served as a Program Analyst at the Center for Consumer Information and Insurance Oversight (CCIIO) division at CMS. From his tenure at CCIIO, Mr. Mercer brings with him substantial expertise covering government health insurance programs with a focus on ACA exchange and Medicare Advantage policy issues and catalysts. As a Program Analyst at CCIIO, some of Mr. Mercer’s core responsibilities included tracking Federal and State legislative and regulatory changes, translating statutory and regulatory requirements into policy guidance, analyzing provisions of the Affordable Care Act for Federal and State regulators as well as health insurers, serving as a health insurance issuer rating subject matter expert, and collaborating with other CCIIO groups and contractors with a primary focus on working with the Federally Facilitated Marketplace development and policy teams. Mr. Mercer holds a JD from Washington & Lee University School of Law and a BA in Economics from the College of William and Mary.
Ms. Gibson joined the Marwood Group in 2013 and is responsible for overseeing due diligence and strategic engagements for healthcare corporations and investors. Ms. Gibson is also a subject matter expert on commercial, Medicare Advantage, and Medicaid Managed Care payor dynamics across provider and HIT sectors. Prior to joining the Marwood Group, Ms. Gibson worked at Truven Health Analytics where she worked with hospital and other large providers on various strategic engagements, with a focus on reimbursement and contracting strategies and designed models to analyze both qualitative and quantitative data for healthcare businesses. Ms. Gibson received her BA degree with honors from the University of St. Andrews.
Mr. Bagel is a public policy expert with more than 15 years of working with federal policymakers and lawmakers to advance regulatory and legislative activities. He previously served as a senior policy advisor at the Department of Health and Human Services Office of the Secretary, attorney with the Office of Management and Budget, and as a law clerk at the US Department of Labor and Health Policy Associate with the Senate Finance Committee.
Mr. Kornfield is a recognized national expert on Medicare Advantage payment policy with mastery of Medicare Part D and the Inflation Reduction Act. His unique combination of working in the public and private sector, gained over 25 years of experience, provides him with an unparalleled and creative perspective on government policy. In his most recent role as a senior consultant, he provided analytic support and strategic advice for clients on a wide range of Medicare policy issues. Prior, he was Vice President of Medicare Policy at America’s Health Insurance Plans, where he led risk adjustment policy discussions with plan members and external stakeholders. He spent 10 years at the Centers for Medicare and Medicaid Services in a variety of roles tied to health plan payment and risk adjustment. During his tenure at CMS, he originated the idea to allow five-star Medicare health plans to market and enroll year-round.