As Medicare Advantage Dominates, What Comes Next?

06/04/25 • 38 min

As Congress focuses on budget reconciliation and debates over Medicaid dominate the headlines, another major shift in health coverage continues quietly but powerfully—the explosive growth of Medicare Advantage (MA). Now covering more than half of all Medicare beneficiaries, MA plans are transforming the health care landscape in ways that can no longer be ignored.

In this episode, Chip Kahn sits down with Molly Turco, a former CMS senior policy advisor and health policy expert at her firm MTT Strategies, to dig into the rise of Medicare Advantage, the challenges it presents for hospitals and patients, and what commonsense policy is needed to ensure the program delivers on its promises.

Key topics include:

Medicare Advantage by the numbers particularly in rural markets;
MA Plans bring added benefits for the consumer but at a cost, including financial warning signs and long-term sustainability;
Hospital and provider obstacles, including prior authorization, observation care, and claim denials; and,
Bipartisan policy shifts focusing on transparency and plan practices.

Guest Bio:

Molly T. Turco is a Medicare policy expert with over 15 years of experience shaping national healthcare strategy. Molly has dedicated her career to helping healthcare work better for people. She recently launched MTT Strategies, where she provides strategic and policy consulting services with a focus on Medicare Advantage and Medicare Part D. She previously served as Senior Policy Advisor for Medicare Advantage and Part D at the Center for Medicare at the Centers for Medicare & Medicaid Services (CMS), where she helped lead major initiatives to improve transparency, payment accuracy, and consumer protections in Medicare Advantage and Part D — including reforms under the Inflation Reduction Act. Prior to her work at CMS, Molly led Medicare policy efforts at the Blue Cross Blue Shield Association and the Better Medicare Alliance. She also brings experience as an investor consultant and public health researcher. Molly holds a BA from Middlebury College and a Master of Public Health from the Dartmouth Institute for Health Policy & Clinical Practice. She lives in Washington, D.C., with frequent trips to her home state of Vermont.

Key topics include:

Medicare Advantage by the numbers particularly in rural markets;
MA Plans bring added benefits for the consumer but at a cost, including financial warning signs and long-term sustainability;
Hospital and provider obstacles, including prior authorization, observation care, and claim denials; and,
Bipartisan policy shifts focusing on transparency and plan practices.

Guest Bio:

Previous Episode

The High Stakes of Medicaid Reform: What Budget Cuts Could Mean for Patients

Medicaid is making headlines on Capitol Hill, and the debate is about more than just crunching numbers—it’s about people. This joint federal-state Medicaid program is a lifeline for millions of Americans, including children, seniors, people with disabilities, veterans, and low-income adults. From primary care to nursing home services, Medicaid provides critical coverage and support. But today, policy proposals under consideration in Washington could put that care at risk.

In this episode, host Chip Kahn is joined by Medicaid policy expert Matt Salo, founder and CEO of Salo Health Strategies and former founding executive director of the National Association of Medicaid Directors. Matt brings decades of experience navigating the intersection of Medicaid and the practical implications of policy changes. Together, Matt and Chip dive into the policy cuts on the table and examine what they mean for patients in communities across the country.

Key topics include:

Medicaid’s design as a complex but critical program;
What’s on the table in Washington from per-capita caps to block grants; and,
The “waste, fraud, and abuse” narrative and downstream effects.

Guest Bio:

Matt Salo is the founder and CEO of Salo Health Strategies, a boutique healthcare consulting firm in the Washington DC area that specializes in strategic advice, health care policy, Medicaid market development and relationship building across 56 states and US territories. The firm capitalizes on decades of experience working with state and federal government officials as well as the full spectrum of Medicaid and broader health care stakeholders ranging from health plans, providers, pharmaceutical companies, foundations, and consumer groups.

Matt is the founding Executive Director of the National Association of Medicaid Directors (NAMD), having started the association in February 2011, and he worked in that role until he stepped down in August 2022. The organization represents the state government leaders responsible for administering the Medicaid program. NAMD was established as a permanent community for state leaders to share best practices, and worked to develop technical assistance, invest in leadership development, and formulate a strong unified voice in communication with Congress, the Administration, and other key national stakeholders. He built the organization from an initial staff of one to a full-time complement of ten staff and an operating budget of more than $3 million.

Matt formerly spent 12 years at the National Governors Association, where he worked on the Governors’ health care and human services reform agendas. His major accomplishments included getting legislation passed that guaranteed state control of the entire $250 Billion tobacco Master Settlement Agreement, which resulted in Forbes Magazine naming NGA one of the nation’s top ten most influential lobbying organizations. He also worked to get legislative approval of more than $100 billion in state fiscal relief during the Great Recession; and in bringing bipartisan groups of Governors together on multiple occasions to reach agreement on Medicaid reform proposals, ultimately serving as the backbone for the Deficit Reduction Act of 2007.

Matt was a substitute teacher for two years in the Alexandria City public school system before joining the DC health policy world. He holds a BA in Eastern Religious Studies from the University of Virginia, and is still trying to find ways to explain how that got him to where he is today.

Matt is a nationally recognized expert in Medicaid, state government, health care reform, federalism, long term care. He was recently named by Washingtonian Magazine as one of the 500 most influential people in Washington DC. He is a member of the National Academy of Social Insurance (NASI), and was recently recognized by the National Academy of State Health Policy as its 2022 Academy Award Winner for a lifetime of contributions to health policy.