Dr. Meena Seshamani
Appearances
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
We were able to use these more advanced lab techniques to identify the genetic strain of that listeria between the people who contracted the listeria and liverwurst from boar's head. We then partnered with the federal government to say, hey, we have this going on. Where else are you seeing listeria?
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
Because a virus or bacteria doesn't say, oh, there's a state boundary, so now I'm not going to cross that state border, right? So we partnered with the CDC to have surveillance tracking across the country And as a result, 200,000 pounds of boar's head liverwurst was recalled. And we managed to stop this outbreak at 60 hospitalizations and 10 deaths before it got worse.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
That is a perfect example of how these quote unquote COVID funds have been used to improve not only the health of Maryland, but the health of the population writ large in our nation. And that it's not just about the funding. It's also about that partnership on the data because the federal government has that perspective.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
has that economy of scale to be able to take what one state is doing and spread it writ large and be able to utilize it across the country. And that is where we need to keep moving forward, not only in our public health surveillance, infectious disease and otherwise, but also in prevention of chronic diseases, in addressing substance use and behavioral health issues.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
So really that is a fundamental... tenant to how we can best improve health in our country, that federal-state partnership.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
I also have my PhD in healthcare economics. And so I have been able to leverage both that on the ground experience as well as my economics and policy expertise both in leading care transformation for a major health system, in leading the Office of Health Reform in the Obama administration as we were implementing the Affordable Care Act, and most recently, leading the Medicare program,
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
I think it is critical and it is a priority for me leading the Department of Health to continue to push these kinds of on the ground, data-driven, thoughtful conversations. Again, healthcare is complex. There is no silver bullet. There is no one way to do things.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
So there are gonna be different ways to approach things, and that is actually a strength when we all come together and we figure out what do we want to try. So absolutely, I'm prioritizing continuing to partner with federal colleagues to engage on what are we seeing on the ground How can we work together to be able to address things in a constructive manner?
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
That also goes to what we do within the state of Maryland. Maryland has a huge asset in all of its people and all of its organizations where we can work with all the organizations in Maryland, the people in Maryland to be able to hear on the ground what is going on so that we can best address their needs. And this is also where I think the state comes into play.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
The Moore-Miller administration just passed its budget. And in fact, really doubling down on the investment in our local communities. I mentioned, Vin, about how at a state level you have that opportunity to connect across programs.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
One innovative way that we're doing so is we're taking some opioid funds and we are now investing in targeted Medicaid interventions for people who are incarcerated 90 days before release. Because we know that if we address substance use disorder for people who are eligible for Medicaid upon release,
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
And we address that while they're still in custody, it increases the likelihood that they will thrive upon reentry and they will not end up in the same boat. And thinking about how bringing together the criminal justice system, the behavioral health system and Medicaid. to really impact this population that otherwise could just end up bouncing back into jail.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
The costs associated with that and the opportunity costs of a life of someone who's not able to interact in society. So I think that there are many ways that the Moore-Miller administration, through this budget, is seeking to really have those innovative ways to continue to move forward along our fundamentals, as we were talking about,
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
And in fact, even with innovative programs like this, this budget balances the budget and actually has $2 billion in cost savings, the most in, I think, at least a decade. for the state of Maryland, because it's all about how do you spend money in a smarter way?
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
And that's the conversation that we are engaged in locally in the state of Maryland to make sure that we are continuing to invest in our communities, in their health and well-being, and that we seek to continue to have with our federal partners.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
where we implemented the Inflation Reduction Act and stood up for the first time the Medicare drug price negotiation in the history of the Medicare program, among many other things that we did. Now I have the opportunity to bring that back to my home state. I moved to Maryland 20 years ago for residency. I suppose I just dated myself.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
Absolutely, number one is improving the health and wellbeing of Marylanders is the vision. How that plays out, in the Department of Health in Maryland, there are four administrations. There's the Public Health Administration, the Developmental and Disability Services Administration, the Hadriel Health Administration, and our Healthcare Financing and Medicaid Administration.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
And I think importantly as a department, being able to, as we were talking about Vin, connect across those so that we can make sure that we are really caring for people, not just treating a particular disease in a particular program, but really thinking across as to how we can continue to innovate, to support more holistic care.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
That includes being able to see how we can most effectively utilize our dollars around chronic disease prevention, public education, around our vaccinations, around our epidemiologic surveillance, to how are we best leveraging our Medicaid program to keep people healthy, to keep them in their communities, to be able to support the myriad of experiences that impact someone's health.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
For behavioral health, I gave you that example of that behavioral health and Medicaid partnership with our criminal justice, with our justice work. and being able to continue to develop a continuum of care and behavioral health where people are cared for at the very early preventive stages, not just when they end up in an institution. And for disability services,
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
That is the true epitome of person-based care, where caring for people with disabilities involves the entire family and the community and also requires us to take a look at how we can continue to provide that top-level care while also looking at our sustainability and making sure that the money goes in the most effective way possible. So really across all of the aspects
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
of our Department of Health, we have the opportunity to touch people's lives in Maryland from the moment they are born, even before they are born, to the day that they die, and really taking that to heart as we do our work.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
That's a great question. And I think it is a combination of things.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
First, I think it's important that we are ensuring quality in our provider community and really making sure that, you know, one of the things that we do is licensing of behavioral health providers and how are we ensuring that people who are providing services are providing quality service and really being able to protect people who seek behavioral health services.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
I think a second area that you mentioned is access. And I think especially with behavioral health, how do we meet them where they are? So another example from our budget is that now we are expanding our mobile crisis program to serve 20 counties where we can go out. to people in urgent behavioral health need with a highly trained team.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
It's wonderful to now have the opportunity to lead health for my home state to really ensure that we are improving the health and well-being of all Marylanders in a holistic way.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
And this again comes back to those connect points where you are then reaching people where they are. You're providing that access for crisis response and then getting them to a same day facility so that they can be better managed to avoid that hospitalization, the ED, you know, boarding that institutional path.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
And there's also, again, that connect point where before someone calls 911 and it goes to the police and are, you know, instead now having this partnership with justice so that we can we can better address what people's needs are. So I think that is another area that we are really focusing on as an example from our current budget.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
Well, first... Absolutely, there is a role for those of us in healthcare to be out there speaking to data, being approachable and answering people's questions, addressing confusion as it arises. This is for someone in my role leading a state department of health, for a clinician like yourself, Vin, right? I mean, people ask their doctors about information.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
to our pharmacists and our nurses and our health plans and our hospitals. However, as a, I think you said I'm a big time healthcare leader, I'm also a healthcare leader who knows that not everybody wants to listen to her. Certainly my children sometimes.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
But also it's so important that we are partnering on the ground with our community partners because they're the ones who are gonna know better what people get, what they don't, how they can take advice and information and apply it in their everyday lives. So I think equally and perhaps even more important than what you or I could do is in this podcast telling everyone
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
Go engage with your local community, with your neighborhood group, with your local place of worship, because that is where a lot of people get their information and that is where they can get information that is much more pragmatic and tangible and actionable for them.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
So it is so important that we are partnering broadly to be able to provide people with info to, again, to come back to where we started, Vin, to return to our fundamentals when we are dealing with all this uncertainty. We have an opportunity to link arms, to roll up our sleeves, and to approach things with our ultimate vision and goal of serving all of our community together.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
Thank you again, Vin, for having me.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
Oh, so Medicare has been in existence since 1965. In 2003, that was the first time that there was a prescription drug benefit in the Medicare program. And the Inflation Reduction Act, or the prescription drug law as we would call it, was really the biggest changes to Medicare prescription drug coverage in two decades since prescription drugs had been brought to the Medicare program.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
So one big piece of that was enabling Medicare to finally negotiate directly with pharmaceutical manufacturers on high-cost drugs. Previously, Medicare could not negotiate directly
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
And so this is a very important opportunity for us to be able to reward the kind of innovation and enable people to have access to that innovation for cures and therapies that people need at a price that they can afford. And in standing up that program, we had to do it in two years. So really engaging people. drug companies, patients, clinicians, health plans.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
How do we set this up in a way that really encourages that innovation for what people need to see, those breakthrough therapies, and also enable people to have access to them? Because you can have all of these innovations, but if people can't access it, then is it really going to help improve the health of populations?
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
And in the first year alone, we had participation for all 10 drugs that were selected, high-cost drugs, common blood thinners that are used, diabetes medications. And we estimated that had those negotiated prices been in place in 2023, it would have saved the Medicare program $6 billion. But even more importantly, I think, it would have saved...
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
People with Medicare out of their own pockets, $1.5 billion. And this really resonates with me because before I took the role leading Medicare, I had one woman who was on Medicare and we would get on our smartphones on GoodRx so that I could try to prescribe her an antibiotic that she could actually afford.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
Now, another provision is that no one pays more than $2,000 in the calendar year for their prescription drugs. So again, this is just one of many examples of where we were able to bring significant improvements to the Medicare program for the 68 million people in this country who really rely on this program to be able to stay healthy and well.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
Well, I think this is where... Medicare really is, and I would say many government programs, there are three levels to them. There's the law that establishes these programs. That's like the 50,000 foot level that gives the creation of a program and the general framework and the legal authorities for implementing a program.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
Then you have the regulations that happen in the executive branch of governments. That's more at the 25,000-foot level, which is where I was when I was leading Medicare and which is where I am now leading the Department of Health in Maryland, where we have legal authorities that are given to us by the legislature. Then how do we implement that to enable people
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
a framework at that 25,000 foot level for then people on the ground to be able to have real impact in the lives of those they serve. And that's that third layer where you have health plans and patients and their families and communities and clinicians and drug manufacturers and others all in that healthcare ecosystem that within the guardrail set by the law and the regulations are now
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
functioning in the healthcare market. And so that's why sometimes it can take a while for a law to change to then enable a change to occur in the regulations and enable a change on the ground. And this is also why it's so important that we are all communicating with each other because none of us alone can fix problems in healthcare and none of us alone can really significantly improve them.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
And you mentioned the drug negotiation. A less well-known perhaps example is that now for the first time, Medicare pays for care navigation and for supporting family caregivers. Those are ideas that came to us directly from Medicare.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
Thank you so much for having me.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
people on the ground from primary care docs who say, you know, I have a patient coming in who has a wound and I'm here trying to tell the family member, here's how you can do the wound care. And, you know, just wondering how that's going to go.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
And that's where it's like, we need to provide some resources because again, we all know that if you can enable people to navigate the system, to get the care they need, to get the care they need at home, You're going to keep them healthier, keep them out of the hospital, enable them to live productive lives.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
So really that partnership and that back and forth is so critical, especially in an area like healthcare, which is very complex and very personally affects all of us.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
Well, I mean, as many of you may have seen, the Trump administration put out a press release saying that they were continuing, put out a statement, I think, saying that they were continuing with the drug price negotiation. We have, again, the legal authorities that must be followed. We also have all of the guidances and regulations that have been put into place that lay the framework for
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
for how negotiation will be done. And my hope is that as this program continues to mature, that there continues to be that dialogue of what are our common goals in healthcare and how can we all work together to achieve them?
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
Absolutely. I mean, I will say there is definitely a lot of uncertainty. There is a lot of change happening. And in times like these, it is so important for us to return to the fundamentals. Why do we go into health care? We want to have a positive impact on people, on our communities, on their lives. And how can we maintain that focus, that North Star, as we are navigating headwinds?
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
Sure. So I feel very privileged to have the opportunity to have this career path that has really enabled me to both take care of people and have impact on the ground and to work at higher levels in policy to really shape the system in which people can care for patients. By training, I am an otolaryngologist or a head and neck surgeon, and I have practiced full time on the ground.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
I will say, one of the reasons that I was so thrilled to have the opportunity to come to Maryland, alongside it being my longstanding home state, is because states really are a laboratory for innovation. Being at a state level, you're really close to the ground with your communities to be able to forge new partnerships and connections, for example, between food and healthcare,
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
or health care or workforce training and health care institutions. There's just those opportunities to really connect the dots and innovate that can be more difficult at a federal level where you are higher up and looking across the entire country. Specifically because at the end of the day, health care is local and does require that state-based view.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
Alongside that important role that states play, there's a very important role that the federal government plays.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
I think there's an opportunity for the federal government, and I did this when I was at Medicare, to see what is happening on the ground, to see where there are innovative ideas and programs that are working, and then how can we take those and scale those so that more people can benefit from them.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
And a way that the federal government does that is both through funding mechanisms and through data surveillance and sharing. And I think a lot of what we are seeing now is disruption in both of those aspects of the federal state partnership where.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
You know, we at the state level are really looking for, you know, innovative ways to continue to improve the health and well-being of our local communities. And that really is that federal-state partnership of having federal funding alongside state funding to be able to support these initiatives. Medicaid is a very good example. Our public health services are a very good example.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
And then there's also that aspect of where we partner with the federal government where something affects not just our state, but the country as a whole. And I'll give you a very tangible example of this. As you and our listeners probably know, the Trump-Vance administration rescinded what's turned the COVID funds. Those are, they're not just for COVID.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
Those are funds for broader public health work that were given and created during the time of the pandemic. So that's why the shorthand is COVID funds, but it's really not for COVID work. It's for laboratory surveillance and more advanced technologies and for public education and outreach and immunization.
The MeidasTouch Podcast
Meidas Health, Episode 5: One of the Nation's Biggest Future Healthcare Leaders Speaks!
And, you know, we used those funds to invest in some of our public health labs for more advanced molecular testing. That may seem to be a very esoteric science geek term, but here's how it applies. There were people who came down with listeria in Maryland.