Redirecting the U.S. health care system away from government regulation and toward free-market competition will nurture innovation, improve care with physicians competing on cost and quality and allow patients to make their own decisions about their care, Seema Verma, Centers for Medicare & Medicaid Services (CMS) administrator, told physicians at the 2019 AMA Annual Meeting.
In a 24-minute speech preceding the business session of the AMA House of Delegates, Verma focused on the CMS Patients Over Paperwork initiative, efforts to simplify the new Medicare payment system created by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), reforming payment for evaluation and management (E/M) services and interoperability of electronic health record (EHR) systems.
She said many well-intended government policies seeking to solve health care challenges have actually exacerbated those problems and led to health care consolidation that has driven up costs and thwarted transparency. Delegates applauded when Verma mentioned how reforms such as site-neutral payments are intended to create a level playing field for independent practices.
The Patients Over Paperwork initiative has saved $5.7 billion since it was instituted in 2017 and is projected to save 40 million “burden hours” through 2021, Verma said.
Regarding MACRA, Verma touted the recent launch of the Primary Care First alternative payment models and moves to simplify the Merit-based Incentive Payment System.
E/M proposal a starting point
She also said CMS is still working on E/M payment reform with the goal of rewarding physicians for their critical thinking in caring for complex patients. This includes payment for interpreting genetic information, analyzing social determinants of health and coordinating care.
This work continues as CMS analyzes the more than 10,000 comments the agency received on reforms proposed last year.
“We heard you loud and clear,” Verma said, saying that the much-criticized proposal was never meant to be the end of the discussion.
Regarding EHR interoperability, Verma said the goal is provide physicians with the data they need at the point of care and to have records that follow patients who have a choice with who they are shared with.
Verma noted the “unique vantage point” of physicians and said that policymakers need to “hear from you and your colleagues.”