It was quite fascinating to cover the speech that Health and Human Services Secretary Alex Azar gave this week in Washington, D.C. In a keynote address on Wednesday morning at the Marriott Wardman Park Hotel, Secretary Azar laid out his agency’s overall policy strategy, for attendees at the World Health Care Congress, which annually gathers together leaders from all the major sectors of the U.S. healthcare industry, from hospitals to physician groups to post-acute and behavioral healthcare, to health plans/health insurers, employer-purchasers, pharmaceutical leaders, and healthcare IT leaders. It’s an ideal venue for senior federal healthcare officials to make announcements—and they usually do show up every year, and sometimes, make news.
Indeed, this year, Seema Verma, Administrator of CMS (the Centers for Medicare and Medicaid Services) had addressed the Congress just two days earlier, on Monday. And while Verma’s and Azar’s speeches contained somewhat similar overall content, both the specifics, and especially, the tone, of the two speeches, differed, with Verma’s tone quite bracing and sharply partisan, while Azar’s was milder and friendlier by far. Where Verma veered strongly into the political realm, saying forcefully that “I take exception to the claims that we are trying to sabotage Obamacare; Obamacare was failing long before Donald Trump became president and I became CMS administrator,” referring to the Affordable Care Act (ACA) passed by Congress and signed into law by President Obama in March 2010, and emphasizing that, “Today, half the counties in America, and 10 states, have no health insurance choices,” Azar took a far more conciliatory tone, focusing on the opportunities for all the stakeholder groups in healthcare to come together.
Beyond the tonal difference, Secretary Azar offered something of a conceptual road map for his listeners, noting that, among the top priorities he would be focusing on in the near future, would be accelerating the value-based transformation of the healthcare system; combatting the opioid abuse crisis; and addressing the cost and quality of U.S. healthcare. Speaking of the healthcare system he envisions, he said that “Such a system will pay for health and outcomes rather than sickness.”
Further, Azar said, “We at HHS know that the idea of value-based transformation is not new. President Bush, in whose administration I served, and President Obama, both worked on this. I personally worked on this under Mike Leavitt,” a Bush Administration HHS Secretary. “HHS has often lagged behind the private sector, where so many of you have made so much progress,” he said. “Everyone here recognizes that the current system will not last,” as it has become unsustainable because of its cost.
Azar cited four top goals for HHS as an agency in the immediate future: “maximizing the promise of health IT; improving transparency in price and quality; pioneering bold new models in Medicare and Medicaid; removing artificial regulatory barriers and burdens that impede care coordination.” And, he added, “The best way to identify and reward value is through a marketplace of many players, and where necessary, through third-party payers.”
As Healthcare Informatics Managing Editor Rajiv Leventhal reported in an article on the new proposed rule for the Inpatient Prospective Payment System (IPPS) announced on April 24, “Regarding transparency, CMS noted that although hospitals are already required under guidelines developed by CMS to either make publicly available a list of their standard charges, or their policies for allowing the public to view a list of those charges upon request, CMS is updating its guidelines to specifically require that hospitals post this information. The agency is also seeking comment on what price transparency information stakeholders would find most useful and how best to help hospitals create patient-friendly interfaces to make it easier for consumers to access relevant health care data so they can more readily compare providers.”
What’s more, CMS had also announced on April 24 its intention to explore creating a direct contracting option for Medicare-participating physicians in practice, as Leventhal noted in a separate article published on that date. That article noted that CMS said on that day that “[T]he agency also said that it would be taking a next step to develop a potential model in direct provider contracting (DPC).” According to CMS, “A direct provider contract model would allow providers to take further accountability for the cost and quality of a designated population in order to drive better beneficiary outcomes. Such a model would have the potential to enhance the doctor-patient relationship by eliminating administrative burden for clinicians and providing increased flexibility to provide the high-quality care that is most appropriate for their patients, thus improving quality while reducing expenditures.” Per that, CMS has issued an RFI (request for information) on the DPC model that runs through May 25, and that follows up on the RFI that had generated many comments from providers interested in contracting directly with CMS in new payment arrangements.