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Sachin H. Jain

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Sachin H. Jain
Born1980 (age 44–45)
New York City, New York, U.S.
EducationHarvard College
Harvard Medical School
Harvard Business School
OccupationPhysician
Known forPresident & CEO of CareMore Health System; role in implementing HITECH Act and ACA
TitlePresident, Chief Executive Officer, SCAN Group and Health Plan
Board member ofAmerica's Health Insurance Plans (AHIP), Omada Health, Advantage Healthcare Services, The Paul & Daisy Soros Fellowships for New Americans.

Sachin H. Jain (born 1980) is an American physician who held leadership positions in the Center for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC).[1] From 2015 to 2020, he served as president and chief executive officer of the CareMore Health System. In July 2020, he joined the SCAN Group and Health Plan as its new president and CEO.[2] He is also adjunct professor of medicine at the Stanford University School of Medicine and a Contributor at Forbes. In 2024, he was named one of the most influential people in healthcare by Modern Healthcare magazine for the second year in a row.

Early life and education

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Born in New York City and raised in Alpine, New Jersey, Jain attended high school at the Academy for the Advancement of Science and Technology (now part of the Bergen County Academies) where he founded the debate team and the Bergen County Leaders Forum and served internships at Memorial Sloan-Kettering Cancer Center; the Office of the Bergen County Executive; and the Bergen County Department of Health Services. He was also a Governor's Scholar on Public Issues and the Future of New Jersey. Jain received his undergraduate degree with high honors in government from Harvard College; his medical degree (MD) from Harvard Medical School; and his master's degree in business administration (MBA) from Harvard Business School. At Harvard College, he was mentored by health care quality guru Donald Berwick and studied under Christopher Winship, Robert Putnam, Deborah Stone, and William Julius Wilson. At Harvard Medical School, he was president of his class and awarded the Henry Asbury Christian Award for research excellence. He and classmate Kiran Kakarala were advised by health policy department chair Barbara McNeil and received hundreds of thousands of dollars in grant support from the Commonwealth Fund to build ImproveHealthCare, an initiative to drive incorporation of healthcare policy into medical school curricula that scaled to 17 US medical schools.

Early work

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Jain completed his residency in internal medicine at Brigham and Women's Hospital and Harvard Medical School, but had been granted a two-year leave mid-residency to pursue government service.[3] He is a founder of several nonprofit health care ventures including the Homeless Health Clinic at UniLu,[4] the Harvard Bone Marrow Initiative,[5] and the South Asian Healthcare Leadership Forum. He worked with DaVita-Bridge of Life to bring charity dialysis care to rural Rajasthan, India[6] and Medical Missions for Children to bring cleft lip and palate surgery to the region through partnership with the International Human Benefit Services Trust.

While in residency, he was a researcher for Harvard Business School's Institute for Strategy and Competitiveness and worked with professors Michael Porter and Jim Yong Kim to build the emerging field of health care delivery science. He served as an expert consultant to the World Health Organization.[7] He later partnered with the University of Pennsylvania's Amol Navathe and the publisher Elsevier to launch the field's charter journal, Healthcare: the Journal of Delivery Science and Innovation.[8][9] He also collaborated with Brigham and Women's Hospital and Harvard Business School to create the John McArthur Program for Medicine Leadership.[10]

Early in his career Jain served internships at McKinsey & Company and the Alpha Center for Health Policy. He was also appointed a lecturer in health policy at Harvard Medical School from 2012 to 2015. He has served as guest faculty at the MIT Sloan School of Management, the University of Minnesota, the University of Virginia's Darden School, University of California San Francisco School of Medicine, Stanford University School of Medicine, and the University of Southern California.

Career

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In 2009, Jain joined the Office of the National Coordinator for Health Information Technology (ONC)[11] as special assistant to David Blumenthal. Jain worked with Blumenthal to implement the HITECH Provisions of the Recovery Act. He also worked on increasing electronic health record usability and [12] private sector engagement on behalf of ONC.[13]

Jain was recruited by his college mentor Donald Berwick as a senior advisor to the administrator at the Centers for Medicare and Medicaid Services and was asked to help lead the launch of the Center for Medicare and Medicaid Innovation (CMMI) that was chartered by Section 3021 of the Patient Protection and Affordable Care Act. He served briefly as its deputy director for policy and programs under Richard Gilfillan, the center's first director.[14] Jain advocated within the administrator's office for speedier translation of health care delivery research into practice; an enhanced diabetes prevention benefit; and an expanded use of clinical registries.[15]

In 2012, Jain was appointed global Chief Medical Information and Innovation Officer of Merck. At Merck, Jain built and led the company's digital health and big data group. In 2015, Jain joined CareMore, an integrated health plan and delivery system. Jain left CareMore and joined SCAN Group and Health Plan, a $3.4b independent managed care company, as its president and CEO.

SCAN Group and Health Plan

In June 2020, Sachin Jain joined SCAN Group and Health Plan, originally known as the Senior Care Action Network. Upon his appointment, Jain announced a strategic focus on growth, diversification, innovation, and improving care for diverse and underserved populations.

Under Jain’s leadership, SCAN’s membership has increased from approximately 225,000 to over 300,000 individuals. During the same period, the organization expanded from a $2.4 billion insurance entity into a $5 billion diversified healthcare company. This transformation included the development of four care delivery subsidiaries:

  • Healthcare in Action: A medical group providing care to older adults and vulnerable individuals experiencing homelessness.
  • Welcome Health: A primary care group offering services to older adults through clinics, home visits, and virtual care.
  • Homebase Medical: A practice delivering palliative care, chronic disease management, transitional care, and in-home health assessments.
  • myPlace Health: An integrated care organization operating under the Program for All-Inclusive Care for the Elderly (PACE) model and partnering with local health plans as a value-based provider.

These assets have had varying levels of success. Healthcare in Action has grown into one of the nation’s largest street medicine providers while Welcome Health has struggled to grow and even changed its business model from home-based care to in-clinic care.

Expansion and Innovation

Beginning in 2021, SCAN expanded its operations beyond California to include New Mexico, Texas, Arizona, and Nevada. That same year, SCAN received its fifth consecutive 4.5-Star rating from the Centers for Medicare & Medicaid Services (CMS). The organization has consistently maintained a CMS Star rating in California of 4 or higher for eight consecutive years, though some people note that SCAN’s Star ratings are lower in Nevada and Arizona, raising questions about whether trying to scale the business may result in diminished quality.

SCAN also launched several specialized Medicare Advantage plans tailored to specific populations, including:

  • Affirm: Designed for LGBTQ+ seniors.
  • Inspired: Targeted toward women aged 65 and older.
  • Allied: Created for Asian American older adults.
  • SCAN Embrace: An institutional special needs plan (I-SNP), which has become one of the fastest-growing I-SNPs in the country, with over 3,500 members.

Like other Jain initiatives, these plans have had variable success. A few industry watchers have noted that the plans don’t differ substantially in benefits from SCAN’s traditional MA products.

In late 2024, Jain appointed former Disney CEO Bob Chapek as a senior advisor to SCAN to enhance the organization’s customer experience. The two have since spoken at healthcare conferences about applying hospitality industry principles to healthcare delivery.

CMS Lawsuit

In 2024, Sachin Jain initiated a lawsuit against the Centers for Medicare & Medicaid Services (CMS) in response to modifications made to the Medicare Advantage Star Ratings program. The legal action resulted in a favorable ruling for SCAN Health Plan, yielding approximately $250 million in additional revenue. These funds were subsequently used to enhance clinical benefits for SCAN members. The case had broader implications across the Medicare Advantage landscape, prompting CMS to recalculate $1.4 billion in payments affecting 60 health plans and approximately one million beneficiaries. The outcome of the lawsuit also encouraged other insurers to pursue similar legal challenges, some of which have since been successful.

Jain maintains a faculty appointment as an adjunct professor at Stanford University School of Medicine and continues to see patients.

Writings

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Jain is a widely read author and thought leader. His Forbes column has more than 10,000 readers and more than 211,000 people follow him on LinkedIn. Jain has authored more than 100 publications on health care delivery innovation and health care reform. His article, "Practicing Medicine in the Age of Facebook," in the New England Journal of Medicine explores the interface between social media and the practice of clinical medicine.[16] He coined the term digital phenotype and described it in a paper in Nature Biotechnology with colleagues Brian Powers, Jared Hawkins, and John Brownstein. Two of his articles in Journal of the American Medical Association, "Societal Perspectives on Physicians: Knights, Knaves, and Pawns?"[17] (with Christine K. Cassel) and "Are Patients Knights, Knaves, and Pawn?"[18] (with John Rother) build on the social theories of Julien LeGrand and apply them to physician and patient motivations. The book he co-edited with Susan Pories and Gordon Harper, "The Soul of a Doctor" has received mixed reviews.[19] His article, "The Racist Patient," was mentioned in the New York Times and generated controversy about the obligation of physicians to patients with racist attitudes towards them and critical comments directed at Jain's perspective.[20]

Honors

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Jain is the subject of a Harvard Business School case study written by dean Nitin Nohria.[21] Jain was selected to Boston Business Journal's 40 under 40 list.[22] He has been named several times to Modern Healthcare's lists of most influential minority health leaders, most influential clinical executives, and most influential leaders in healthcare. In 2024, he was named one of American healthcare's most influential people in healthcare. In 2025 he was named to the Becker’s Hospital Review list of great leaders and the Los Angeles Business Journal added him to its annual LA 500 list.

References

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  1. ^ "World Health Care Congress – Official Biography". World Healthcare Congress.
  2. ^ "PatientsLikeMe Collaborates with Merck - 08/17/2012 - the Burrill Report". Archived from the original on 2015-01-18. Retrieved 2012-08-19.
  3. ^ "World Healthcare Congress Speaker Biographies". Archived from the original on 2011-07-26. Retrieved 2011-05-28.
  4. ^ Brownell, Matthew. "Writer, Reformer, Physician-in-Training". Harvard Magazine.
  5. ^ Nemerenco, Daniela. "Bone Marrow Drive Launched". The Harvard Crimson. Archived from the original on 2012-10-06. Retrieved 2011-05-30.
  6. ^ "Bridge of Life DaVita Medical Missions". Renal Business Today. 8 November 2008. Archived from the original on 8 September 2012.
  7. ^ "Report on the expert consultation on positive synergies between health systems and Global Health Initiatives" (PDF). World Health Organization (WHO). Archived (PDF) from the original on 2021-02-23. Retrieved 2020-10-05.
  8. ^ "Redefining Health Care Curriculum". Archived from the original on 2011-06-07. Retrieved 2011-05-30.
  9. ^ "Young President's Organization Health Care Speaker Series" (PDF). Archived (PDF) from the original on 2012-03-24. Retrieved 2011-05-30.
  10. ^ Jain, Sachin H.; Goodman, Elaine B.; Powers, Brian W.; Katz, Joel T. (2016). "The residency-MBA program: A novel approach to training physician leaders". Healthcare. 4 (3): 142–144. doi:10.1016/j.hjdsi.2015.10.009. PMID 27637817.
  11. ^ "Official HHS Bio from Office of National Coordinator for Health Information Technology". Archived from the original on July 9, 2012.
  12. ^ Morrisey, John. "Uncle Sam Wants Usability!". Government HealthIT. Archived from the original on 2011-05-30. Retrieved 2011-05-28.
  13. ^ Jain, Sachin; Seidman, Josh; Blumenthal, David (September 2010). "How health plans, health systems, and others in the private sector can stimulate 'meaningful use'". Health Affairs. 29 (9): 1667–1670. doi:10.1377/hlthaff.2010.0766. PMID 20820024.
  14. ^ McKethan, Aaron; et al. (2011). "An Early Status Report on the Beacon Communities Program". Health Affairs. 30 (4): 782–8. doi:10.1377/hlthaff.2011.0166. PMID 21471501.
  15. ^ Berwick, DM; Jain, SH; Porter, ME (2011). "Clinical Registries: The Opportunity for the Nation". Health Affairs. doi:10.1377/forefront.20110511.010833. Archived from the original on 2022-03-29. Retrieved 2022-03-29.
  16. ^ Jain, SH (13 August 2009). "Practicing Medicine in the Age of Facebook". New England Journal of Medicine. 361 (7): 649–51. doi:10.1056/NEJMp0901277. PMID 19675328.
  17. ^ Jain, Sachin H.; Cassel, Christine K. (2010). "Societal Perceptions of Physicians". JAMA. 304 (9): 1009–10. doi:10.1001/jama.2010.1250. PMID 20810381.
  18. ^ Jain, Sachin H.; Rother, J. (2011). "Are Patients Knights, Knaves, or Pawns?". JAMA. 305 (20): 2112–3. doi:10.1001/jama.2011.694. PMID 21610245.
  19. ^ Hull, Sharon K. (2006). "Training". JAMA. 296 (9): 1141. doi:10.1001/jama.296.9.1141.
  20. ^ Chen, Pauline W. (25 July 2013). "When the Patient Is Racist". The New York Times. Archived from the original on 13 September 2013. Retrieved 30 July 2013.
  21. ^ Nohria, Nitin. "Sachin Jain: Life Story of A Recent MBA". Harvard Business School Press.
  22. ^ "BBJ names 2012's 40 under 40 honorees". Archived from the original on 2013-09-17. Retrieved 2013-09-17.
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