Now that key leaders at two major federal healthcare agencies have been confirmed to their posts—Health & Human Services (HHS) Secretary Tom Price, M.D., Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma, and John Fleming, M.D., deputy assistant secretary for health technology (a new position created at HHS)—various health IT leaders have turned their attention to working with the departments on their core priorities for the industry. And while healthcare trade association groups have done just that in recent days, they are still very much in wait-and-see mode as Price, Verma and Fleming settle into their new leadership roles.
Certainly, the new federal officials have a lot on their plates and will need time to get up-to-speed and briefed; Verma, for one, was confirmed just two weeks ago, and Fleming just days ago. Also, the recent focus of President Trump, from a healthcare standpoint, had been on the attempt to repeal the Affordable Care Act (ACA), but now it seems that with the recent developments on Capitol Hill, the administration will be moving onto other priorities.
Prior to last week’s news of the ACA repeal failure, there had been legitimate questions as to whether or not Trump’s attention on the repeal was pushing other delivery system reform efforts to the back of the line. In a recent interview with Healthcare Informatics, Leslie Krigstein, vice president for congressional affairs at the Ann Arbor, Mich.-based College of Healthcare Information Management Executives (CHIME), indeed hinted this was the case. Krigstein said,”…Just the fact that they’re still getting staffed up is why we haven’t seen that much activity; and also the fact that they had all hands on deck for the ACA effort that’s now ended.”
As such, Krigstein noted in that interview that Price, Verma and others could act quickly now that the ACA repeal is no longer a core emphasis of the administration. She said, “Yes, I think we’ll see some fairly swift action, and maybe around IPPS [the Inpatient Prospective Payment System payment rule] and MACRA [the Medicare Access and CHIP Reauthorization Act of 2015].”
Meanwhile, CHIME has offered its support for Price and Verma as they ease into HHS and CMS. In a separate interview from the aforementioned one, Krigstein says that as an organization, CHIME has worked closely with Price in the past when he was a member of the House. She notes that he co-sponsored a few different meaningful use-related bills, signed a few health IT-related letters, and asked a lot of questions during Congressional hearings on MACRA. “We feel comfortable with his track record, [given] the health IT and meaningful use issues from a provider perspective,” Krigstein says. “He’s been sympathetic to the need for flexibility and rethinking of the meaningful use program. So from that standpoint, we were pleased to see him confirmed. And now that he is on the administration, we’re looking forward to see some of those efforts from Congress carry over into his new capacity of HHS Secretary.”
Verma, on the other hand, is a lesser known figure to health IT folks. But as Mari Savickis, vice president, federal affairs at CHIME, says, the remarks she made during her Senate confirmation hearings on the need for EHR [electronic health record] efficiencies lead to reason for optimism “We are looking forward to getting to know her and working with her. We understand there’s a lot going on right now,” Savickis says, suggesting that not everything will happen all at once in 2017.
To this end, Savickis says that the next step is waiting for CMS to put something in the IPPS proposed rule in April, which could include key information regarding the future of the meaningful use program. “We’re banking on that,” Savickis says. “The first major regulatory vehicle that we expect to see has to do with their direction on meaningful use. We might see a delay [to Stage 3] as they might need to recalculate what’s needed for that stage, and that’s ok, too. When you walk into a new administration, there’s a lot to deal with, there are new people, so if you don’t get everything you want this year, that doesn’t necessarily mean you are getting a lump of coal.”
Nonetheless, Savickis further says that a robust conversation is needed about aligning MIPS (the Merit-Based Incentive Payment System) on the clinician side with the hospital side, as currently, MIPS reporting does not impact hospitals. “That’s a conversation worth having,” she says. “We also do not have the new advisory committee that was created in the 21st Century Cures Act, which will begin this summer. So they have to time their footing; there are a lot of pieces,” she adds.
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