Age of Action: Grab CMS Calls to Reimagine Medicare

For the first time in a century, the United States is on the verge of a historic demographic shift: According to the latest U.S. census data, older people are expected to surpass children in the next decade. As this shift takes shape, it urgently needs to rethink how our healthcare system supports the aging population. Older people face increasingly complex decisions around coverage, nursing visits and social determinants of health outcomes.

That’s why it’s encouraging to see the recent release of Medicare & Medicaid Services (CMS) (CMS) on how to improve access, equity and outcomes for Medicare beneficiaries. This is not only a signal to innovators, but also an opportunity to shape future technologies that can actively address the challenges of aging in the United States.

We have made a big leap before. The last big-tech driver of Medicare is the national focus on interoperability, which lays the foundation for better data sharing across the ecosystem. That foundation is crucial – but not enough. The next leap is action.

Now we have the opportunity to go beyond interoperability and redesign how beneficiaries interact with Medicare. Specifically, we can make revenue data public and machine readable so that the generated AI models can power a truly seamless, intuitive navigation experience. These models can meet older people in which they are, reduce friction, reduce the burden of health literacy, and eliminate coverage that often exacerbates inequality.

We can also help these same systems understand the clinical needs of beneficiaries and provider networks, connecting them directly to the right care, not just in theory, but in practice. The combination of coverage awareness and care navigation powered by proxy AI has the potential to change the way older people interact with the healthcare system.

In this way, we unlock three transformations:

1. Simplify navigation

The Medicare landscape is a maze. The generated AI has enabled interfaces that adapt to different languages, cognitive needs and literacy levels. When data can be accessed and planned for use by these tools, we will move from providing information to enabling action. Navigation becomes personalized and proactive.

2. Linking health and social needs

Many of the most pressing obstacles faced by older people are not medicine—they are social. Agent-based AI systems can unify the interests of Medicare Advantage through state, federal, veterans and community programs to fully meet these needs. They can also develop further by guiding the elderly to apply, dispatch services and confirm receipts. That’s how we last mile.

3. Increase access to quality care

For many Medicare beneficiaries, identifying the care required, confirming insurance and booking an appointment may be like a full-time job. AI-powered systems can surface gaps in care, confirm eligibility and program services – whether it is an annual health visit or expert recommendation. When beneficiaries guide these steps with an interconnected experience, we reduce delays, improve quality and tighten gaps.

CMS RFI is not just a moment of feedback. Here is the blueprint for Medicare’s next chapter, which works on the system, not the other way around.

The goal is not only to help older people live longer. This is giving them more life in those years. This means access, dignity and independence, and technology can help us unlock this opportunity.

Photo: Gustavofrazao, Getty Images

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