CMS Makes a Big Splash with Verma’s Speech, But What Does It Really Mean? | Mark Hagland | Healthcare Blogs Skip to content Skip to navigation

CMS Makes a Big Splash with Verma’s Speech, But What Does It Really Mean?

March 8, 2018
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Seema Verma and Alex Azar made high-profile speeches this week—but what might happen next?

She couldn’t have picked a better moment, or a better venue: when Seema Verma, Administrator of the federal Centers for Medicare and Medicaid Services (CMS), got up to speak on Tuesday morning at HIMSS18, unfolding here in the Sands Convention Center in Las Vegas, she had the entire healthcare IT industry, and much of the U.S. healthcare industry more broadly, listening to her.

And what Verma had to say was substantive, announcing the launch of a new initiative called “MyHealthEData,” aimed at revolutionizing the relationship of U.S. healthcare consumers to their patient data. As the announcement, published on the CMS website at about the same time Verma was speaking at HIMSS18, said, “Last year President Trump issued an Executive Order to Promote Healthcare Choice and Competition Across the United States. In response the Administration is moving towards a system in which patients have control of their data and can take it with them from doctor to doctor, or to their other healthcare providers. The government-wide MyHealthEData initiative is led by the White House Office of American Innovation with participation from the Department of Health and Human Services (HHS) – and its Centers for Medicare & Medicaid Services (CMS), Office of the National Coordinator for Health Information Technology (ONC), and National Institutes of Health (NIH) – as well as the Department of Veterans Affairs (VA). The initiative is designed to empower patients around a common aim - giving every American control of their medical data. MyHealthEData,” the CMS announcement said, “will help to break down the barriers that prevent patients from having electronic access and true control of their own health records from the device or application of their choice. Patients will be able to choose the provider that best meets their needs and then give that provider secure access to their data, leading to greater competition and reducing costs.”

Verma spoke passionately about the need to give healthcare consumers/patients more control over their data and information, citing an experience she had had personally, when her husband suffered heart failure while she was traveling, and when as a result, a series of unfortunate developments took place that might have unfolded very differently had she, as the spouse of a patient in an emergency medical situation, been empowered to access her husband’s data to support his emergency care.

“The reality,” Verma said, “is that once the information is freely flowing from patient to provider, the advances in coordinated, value-based care, will be greater than anything we could imagine today. Things could have been different for my family if my husband could have authorized me to have his health records on his phone,” she said. “Or if he could have notified me that he was in distress. And better yet, maybe we could have predicted his cardiac arrest days before, if his watch could have tracked his health data, and sending that data to alert his doctor, and possibly prevent what happened. My husband is part of the 1 percent that survives his condition. We shouldn’t have to depend on chance” for that type of outcome, she emphasized.

Moving back to the federal policy level, Verma told her audience Tuesday that, “Through the MyHealthEData initiative, this administration is focused on putting patients first, truly first, by giving them the information they need to truly improve their health. This administration will pull every lever to create a health information ecosystem that tailors the health system” to improve outcomes. And she insisted that “Our administration is completely aligned”—including across the Veterans Administration healthcare system, the Department of Defense, and other healthcare-related federal agencies—to achieve this goal. And the time is now. Hospitals and doctors” have extensive access to electronic patient records, she noted, “and nearly everyone has access to a smartphone. And smartphones in particular create the portability needed to create mobility… Uniform standards being drafted in the 21st Century Cures Act that will allow for information-sharing. The technology and regulatory requirements are finally coming together,” she emphasized.

Azar reinforces Verma’s message, with one of his own

Meanwhile, Verma’s speech turned out to not have been an isolated event this week, as federal healthcare officials made comments that reinforced her points, in a variety of venues and situations. Alex Azar, the new Secretary of Health and Human Services, caused his own splash this morning with a speech given in Washington, D.C. for America’s Health Insurance Plans (AHIP). According to the transcript of the speech that HHS posted on its website this morning, Azar said, among other things, that “This administration and this President are not interested in incremental steps. We are unafraid of disrupting the system simply because it’s backed by powerful special interests.”

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Mark, I found this blog very thought-provoking. I had some of the same reactions to the announcements at HIMSS this week. Indeed, no one opposes patients having more acces to their data. But the HHS officials stress that the value in patients having data is to make the healthcare system more "consumer-based," which to me means they envision us shopping for ER visits the way we do furniture. To me, that suggests ideological blinkers of an almost Ayn Rand sort -- markets are good, regulation bad. Is there an example of this working in healthcare somewhere? I remember an insurance CEO once telling me that the problem with insurance is that patients don't have enough "skin in the game." In other words, if you have a knee injury, they want you to really be in a lot of pain before you are willing to fork over the $1,000 for an MRI out of your own pocket. If you don't have the $1,000, tough luck. That is "consumer-based" healthcare. 

The insurance I have right now is a very narrowly focused PPO. If I go outside that network, I pay most of the cost myself. How would transparent pricing info help me in that situation? 

Here is the key takeaway from your piece: 

So here’s the nub of the profound question facing Azar, Verma, and everyone else in this administration, at the highest levels of federal healthcare policy: can the precisely right combination of federal government interventions force the U.S. healthcare system to respond in a “market-driven” way? In a “consumer-driven” way? That’s the gamble these federal healthcare officials are taking, both rhetorically and strategically. It’s one thing to say that healthcare consumers, armed with more data and information, and in control of their own patient records, will force the nation’s health insurers, hospitals, physicians, and all the other types of healthcare entities, to provide higher-quality, more efficient, more cost-effective, more consumer-centric, more satisfying care delivery, care management, and the like. But will that be the reality?

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