Can states build a healthier health system? Maryland is trying with Meena Seshamani

Today’s guest, Dr. Meena Seshamani, ran Medicare at CMS and is now Secretary of Health in Maryland. She is leading one of the country’s most ambitious health reform efforts: evolving Maryland’s all-payer model, expanding investment in primary care, and using data infrastructure to strengthen coverage and population health—all while navigating the implementation of HR1. In this conversation, recorded at Aspen Ideas Health, Meena makes the case that policy design matters, but implementation is where its promise is realized or lost.

Meena and Claudia discuss:

• How Maryland saved $1.6 billion for Medicare
• New primary care investment strategies
• How the state is leveraging CRISP, the state’s HIE, to implement HR1 and streamline enrollment in public programs

Meena shares how Maryland is strengthening food systems using rural health transformation funding:

“We are also taking rural health transformation dollars and investing in cold storage, food aggregators, and distribution hubs for our local Maryland farms, so that when we are doing outreach on healthy eating and providing nutritious food to people, that's actually coming from our local Maryland farms. So it's boosting the local economy in our rural areas as well.“

Relevant Links

Maryland’s Total Cost of Care Model: Evaluation of the First Four Years

Article on the impact of Maryland’s model

How CRISP supports Medicaid redetermination

The state’s Rural Health Transformation plan

About Our Guest

Meena Seshamani, MD, PhD serves as the Secretary of Health for Maryland in the Moore-Miller Administration, where she stewards a $20 billion health system that encompasses public health, Medicaid, disability, behavioral health, and 11 state-run hospitals. She leads the state’s mission to improve the health and well-being of all Marylanders through a focus on accessibility, affordability, and equity.

Under her leadership, Maryland has emerged as a national laboratory for healthcare innovation. Dr. Seshamani successfully negotiated a first-of-its-kind, multi-billion dollar healthcare payment model with federal partners and secured $168 million in inaugural funding to transform rural health delivery. Her tenure is also marked by a proactive approach to public health, exemplified by ensuring broad vaccine access in the state through the creation of a landmark program providing free vaccines to uninsured and underinsured residents—codifying health security as a statewide priority.

Prior to her cabinet appointment, Dr. Seshamani served as Deputy Administrator and Director of the Center for Medicare at CMS. There, she executed the most significant pharmaceutical reform in decades: the Medicare Drug Price Negotiation program, achieving $6 billion in first-year savings. Her work at CMS fundamentally shifted the Medicare model to value-based care by introducing payments for community health services, caregiver training, and navigating patient care, while simultaneously tightening accountability and oversight.

A board-certified head and neck surgeon and an Oxford-trained health economist, Dr. Seshamani’s perspective is grounded in how health care policy and operations impact the real lives of patients. She previously served as Vice President of Clinical Care Transformation at MedStar Health, maintaining a surgical practice while leading large-scale system changes.

A widely published author in the New England Journal of Medicine and JAMA, her insights are frequently sought by The New York Times, The Wall Street Journal, and major news networks. Dr. Seshamani holds her MD from Johns Hopkins University and her PhD from the University of Oxford, where she was a Marshall Scholar.

Source

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