President-elect Donald Trump is set to name Tom Price, M.D. (R-GA) as U.S. Department of Health and Human Services (HHS) Secretary, and Seema Verma as Centers for Medicare and Medicaid Services (CMS) Administrator.
Price, 62, a retired orthopedic surgeon, emerged as a frontrunner for HHS Secretary after reports surfaced on Nov. 16 that the Georgia Republican Representative was at the Trump Tower in New York City. Price, an early Trump supporter, has been a leading GOP voice against Obamacare, which the President-elect has promised to “repeal and replace.” To this end, Trump has also named Seema Verma, 46, current president, CEO and founder of SVC, Inc., a national health policy consulting company, as CMS’ new chief. According to a Reuters report, “Trump cast Price and Verma as a ‘dream team’ to help him once he takes office on Jan. 20 with his campaign pledge to repeal Obamacare.”
The health IT industry is more likely to be familiar with Price than Verma, as the former has been active in pressing the Administration and its colleagues to provide more regulatory relief for physicians. Price is a chairman on a Congressional health subcommittee, the Committee on Ways and Means, through which he has previously voiced concerns about the Medicare Access and CHIP Reauthorization Act (MACRA). He also has advocated for shorter Meaningful Use reporting periods and more flexibility in terms of applying for MU hardship exemptions. It should also be noted, however, that Price did vote in favor of MACRA.
When the MACRA final rule was released in October, Price released a statement that read, "We are deeply concerned about how this rule could affect the patient-doctor relationship, and I look forward to carefully reviewing it in the coming days to determine whether the Administration has addressed those concerns and put the interests of patients first.” In the days leading up to the release of the MACRA final rule, Price and other members of the House Congressional Doctors Caucus sent a letter to CMS urging the agency to carefully address a number of multi-layered, high-level concerns that physicians will face on January 1, 2017 under the new payment system established under MACRA.
What’s more, in September, Price and nearly 200 other federal lawmakers wrote a letter to CMS calling out the Obamacare-created Center for Medicare and Medicaid Innovation (CMMI) for overstepping its authority by proposing mandatory healthcare payment and service delivery models. The letter, which was signed by 179 members of Congress, stated that three recently proposed mandatory models [including the agency’s Comprehensive Care for Joint Replacement (CJR) bundled payment model for hip and knee replacements] demonstrate that CMMI has “exceeded its authority, failed to engage stakeholders and has upset the balance of power between the legislative and executive branches.”
Currently, HHS is led by Sylvia Mathews Burwell, who was sworn in as the 22nd Secretary of Health & Human Services on June 9, 2014. As the Secretary of HHS, Burwell oversees more than 77,000 employees, and has worked closely with other federal agencies within it, such as CMS and the Office of the National Coordinator for Health Information Technology (ONC) on healthcare reform, including leading national health IT efforts.
When reached for comment about the selection of Price for HHS Secretary, Jeffrey Smith, vice president of public policy at the American Medical Informatics Associations (AMIA) noted his insight and knowledge of health IT and healthcare policy. “Price and his staff demonstrated a strong grasp of the issues impacting clinicians participating in the EHR Incentive Program,” Smith said in an emailed response. He added, “I suspect Rep. Price will make good on his reputation as a policy wonk and work to understand the enormous complexities of our healthcare system. And as a physician, he may be willing to re-examine ways to push value-based care without some of the bureaucracy, such as our onerous clinical documentation system and our complex electronic quality measurement paradigm.”
Meanwhile, Verma is set to take over for current CMS Acting Administrator Andy Slavitt, who joined CMS on July 8, 2014 as Principal Deputy Administrator. Verma “worked with Vice President-elect Mike Pence, the governor of Indiana, on a compromise to expand Medicaid coverage for the state's poor with federal funding. The Indiana program requires beneficiaries to make monthly contributions to health savings accounts,” according to Reuters.
And, according to Verma’s bio on SVC, Inc.’s website, “For over 20 years, Ms. Verma has worked extensively on a variety of policy and strategic projects involving Medicaid, insurance, and public health, working with Governor's offices, State Medicaid agencies, State Health Departments, State Departments of Insurance, as well as the federal government, private companies and foundations. Ms. Verma has extensive experience redesigning Medicaid programs in several states. Ms. Verma is the architect the Healthy Indiana Plan (HIP), the nation's first consumer directed Medicaid program under Governor Mitch Daniels of Indiana and Governor Pence’s HIP 2.0 waiver proposal. Ms. Verma has supported Indiana through development of the historic program since its inception in 2007, from development of the enabling legislation, negotiating the financing plan with the state’s hospital association, developing the federal waiver, supporting federal negotiations and leading the implementation of the program, including the operational design.”
President-elect Trump said in a statement, per a Politico report on the morning of Nov.29, “I am pleased to nominate Seema Verma to serve as Administrator of the Centers for Medicare and Medicaid Services. She has decades of experience advising on Medicare and Medicaid policy and helping states navigate our complicated systems. Together, Chairman Price and Seema Verma are the dream team that will transform our healthcare system for the benefit of all Americans.”
Of Price, Trump said in a statement, per the Reuters report: “He is exceptionally qualified to shepherd our commitment to repeal and replace Obamacare and bring affordable and accessible healthcare to every American."
Last year, Price introduced H.R. 2300, the Empowering Patients First Act—legislation that fully repeals Obamacare. According to a press release from Price’s office at the time, “The Empowering Patients First Act puts patients, families and doctors in charge by focusing on the principles of affordability, accessibility, quality, innovation, choices and responsiveness. Those principles form the foundation of the solutions in H.R. 2300—solutions including individual health pools and expanded health savings accounts, tax credits for the purchase of coverage and lawsuit abuse reforms to reduce the costly practice of defensive medicine. The solutions in the Empowering Patients First Act will get Washington out of the way while protecting and strengthening the doctor-patient relationship.”
Senate health committee Chairman Lamar Alexander (R-TN) released a statement on the selection of Price that said, “Dr. Price has a thorough understanding of healthcare policy and the damage that Obamacare has caused—he can see the view from the doctor's office as well as from the lawmaker's office. I look forward to working with him to find a responsible way to replace and then repeal Obamacare so we can move most healthcare decisions out of Washington, D.C., and back to states and patients.”
The College of Healthcare Information Management Executives (CHIME) released a statement on both of Trump’s selections that read, “Rep. Tom Price has been at the forefront of advancing important reforms to the nation’s health IT policy landscape. He was a leader in pushing for greater flexibility in the Meaningful Use program, including the 90-day reporting period. The shorter reporting period is a more realistic timeframe and will help hospitals stay focused on optimizing electronic health record systems for improved patient care. Dr. Price was also instrumental in 2015 in extending the timeline for providers to apply for hardship exemptions under the Meaningful Use program.”
The statement continued, “Health information technology plays a pivotal role in virtually every aspect of healthcare and is moving us toward better, safer, more efficient care. Once they are confirmed by the Senate, we stand ready to continue our work with the leadership team at HHS, including Dr. Price and Seema Verma at the Centers for Medicare and Medicaid Services, to develop policies that will better enable CHIME members to implement IT solutions that transform the nation’s healthcare system.”
It remains unclear on what Trump’s specific position on health IT is, though he has talked about telehealth for veterans on his campaign trail. Trump has been highly outspoken about his desire to repeal the Affordable Care Act, and questions have thus been raised about how this will affect healthcare’s value-based future.