Medicare at a crossroads: A conversation with Dr. Mark McClellan on program reforms and the growth of Medicare Advantage.

The Medicare program is rapidly evolving-a reality that presents unique challenges to policymakers. In this conversation, Mark McClellan, the former commissioner of the US Food and Drug Administration and administrator of the Centers for Medicare & Medicaid Services (CMS), offers his perspective on how policy can adapt to the changing environment. He emphasizes several reasons why the Medicare Advantage program's rapid growth in recent years is increasing pressure for reform and how the CMS Innovation Center and other initiatives can play a role in that effort. Among possible reforms, he discusses the prospects of legislation to alter the use of controversial practices by insurers, like prior authorization. Finally, he offers his perspective on what role Traditional Medicare might play in the program's future.