The Age of Action: Seizing CMS’s Call to Reimagine Medicare

For the first time in a century, the United States is on the brink of a historic demographic shift: According to the latest U.S. Census data, older adults are projected to outnumber children within the next decade. As this transformation takes shape, it brings with it an urgent imperative to rethink how our healthcare system supports aging populations. Older adults face increasingly complex decisions around coverage, care access, and the social determinants that shape health outcomes.

That’s why it was encouraging to see the Centers for Medicare & Medicaid Services (CMS) recently issuing a request for information (RFI) focused on how technology can improve access, equity, and outcomes for Medicare beneficiaries. This is not just a signal to innovators — it’s an opportunity to shape a future where technology can actively solve the challenges of aging in America.

We’ve had a major leap forward before. The last big technology-driven push in Medicare was the national focus on interoperability, which laid the groundwork for better data sharing across the ecosystem. That foundation is critical — but it is no longer enough. The next leap is action.

We now have the chance to move beyond interoperability and redesign how beneficiaries interact with Medicare. Specifically, we can make benefit data public and machine-readable so that generative AI models can power truly seamless, intuitive navigation experiences. These models can meet older adults where they are, reducing friction, lowering the burden of health literacy, and removing barriers to coverage that often exacerbate inequity.

We can also help these same systems understand a beneficiary’s clinical needs and provider network, connecting them directly to the right care — not just in theory, but in practice. The combination of coverage awareness and care navigation powered by agentic AI has the potential to transform how older adults engage with the healthcare system.

In doing so, we unlock three transformational shifts:

1. Simplifying navigation

The Medicare landscape is a maze. Generative AI is already enabling interfaces that adjust to different languages, cognitive needs, and literacy levels. When benefit and plan data is accessible and structured for use by these tools, we move from giving information to enabling action. Navigation becomes personalized and proactive.

2. Connecting health and social needs

Many of the most pressing barriers facing older adults aren’t medical — they’re social. Agent-based AI systems can unify Medicare Advantage benefits with state, federal, veterans, and community programs to address those needs holistically. They can also go further by guiding older adults through applications, scheduling services, and confirming receipt. This is how we go the last mile.

3. Increasing access to quality care

For many Medicare beneficiaries, identifying the care they need, confirming coverage, and booking an appointment can feel like a full-time job. AI-driven systems can surface gaps in care, confirm eligibility, and schedule services — whether it’s an annual wellness visit or a specialist referral. When beneficiaries are guided through these steps in one connected experience, we reduce delay, improve quality, and close critical gaps.

The CMS RFI is not just a moment for feedback. It is a blueprint for the next chapter of Medicare, one where the system works for people, not the other way around.

The goal isn’t just to help older adults live longer; it’s to give them more life in those years. That means access, dignity, and independence, and technology can help us unlock that opportunity.

Photo: gustavofrazao, Getty Images

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