Verma Highlights CMS Initiatives to Empower Patients and Promote Competition

As healthcare spending continues to grow at a faster rate than the overall US economy, Seema Verma sees it as her responsibility as CMS’ administrator to do everything she can to overcome the looming healthcare crisis.

At the 15th Annual World Health Care Congress, Verma highlighted new policies and initiatives from CMS to ensure programs are delivering high-quality care in a sustainable way. The size of CMS is so large that everything it does has a significant effect on Americans and the care delivery system. That responsibility to the healthcare system is on Verma’s mind for every decision made.

Anyone who simply suggests more government funding doesn’t fully grasp the situation, she said, since there has already been a huge increase in funding and CMS puts out 11,000 pages of regulation every year. Despite that, healthcare challenges continue to worsen in the United States, she said.

CMS has been following President Donald Trump’s executive order to promote healthcare choice and competition.

“He wants his administration working to foster competition in healthcare markets so patients and the American people may receive better value for our investment in healthcare,” Verma said.

Among these initiatives is MyHealthEData, which will empower patients by giving them control of their own health records.

“We made it clear that the days of finding creative ways to track data in closed systems must come to an end,” Verma added. “It is no longer acceptable to limit patient records or prevent them and their doctors from seeing their complete history.”

CMS has proposed imposing financial consequences for hospitals that don’t give patients access and making it a condition of participating in Medicare that hospitals share records.

The agency is also working to advance price transparency, since healthcare is essentially the only sector where consumers don’t know the price of services before they purchase them. A proposal would require hospitals to post their charges online.

During the speech, Verma also vehemently defended the Trump administration and its approach to the Affordable Care Act (ACA). She said that the ACA, which is currently insuring 11 million Americans, was “failing” long before Trump’s presidency and her tenure as CMS administrator with rapidly increasing premiums and half of the counties in the country.

“We have spent the past year working hard to mitigate the damage caused to Americans by Obamacare,” Verma said. “So, I take exception to those out there who have made claims that we have tried to sabotage the healthcare of the American people.”

Without Congress acting to pass legislation to repeal, replace, or fix the ACA, the administration is doing what it can to stabilize the markets and provide more choices, she said. Among the changes CMS has enacted was cleaning up the regulations so states have greater flexibility and control of their markets and the proposed expanded use of short-term health plans.

Unlike the previous administration, which Verma said had been resistant to state-level efforts to create waivers, the current administration is partnering with states to help them serve the unique needs of their citizens. Under the ACA, Verma said, the Medicaid safety net has been stretched to accommodate able-bodied working-age adults who have gained coverage, possibly at the risk of the country’s most vulnerable patients.

CMS’ new openness to state waivers for the Medicaid program provides these able-bodied adults with “supports and services they need to rise out of poverty,” Verma said.

Ultimately, the goals of CMS’ recent policy changes have all started with putting patients first. For hospitals and providers, it is through more price transparency, reduced administrative burden, and patient control over medical records. For states, it is through greater flexibility.

“We need to work together to create a healthcare system that pays for value, not merely volume,” she said.