2017 was a year of tremendous uncertainty for healthcare providers. After spending the previous several years adjusting to the realities of and complying with The Affordable Care Act (ACA), the provider community watched President Trump take office last January and install Tom Price as Secretary of the U.S. Department of Health and Human Services (HHS) with a promise to aggressively pursue the repeal of major elements of the law.
By the end of the year, however, those legislative efforts had ended in a series of unsuccessful votes and former HHS deputy secretary and pharmaceutical industry executive Alex Azar had been nominated to replace Price as the nation’s top health official. Unsurprisingly, this left many providers more uncertain than ever about what to expect from Washington, D.C. in 2018.
In response, under the new leadership of Secretary Azar, the Administration has pivoted from last year’s efforts to repeal the ACA and towards four new priorities for 2018: (1) combating the opioid crisis; (2) bringing down the high price of prescription drugs; (3) addressing the cost and availability of insurance; and (4) the value-based transformation of America’s healthcare system.
For providers, the Administration’s endorsement of the transition to a value-based system is without question the most significant of these new goals, especially given the ACA’s overlap with MACRA and other value-based programs such as accountable care organizations (ACOs).
Secretary Azar and Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma used a series of March speeches to outline the Administration’s vision for value-based transformation. Central to that vision are four goals: (1) giving consumers greater control over health information through interoperable and accessible health information technology; (2) encouraging transparency from payers and providers; (3) using experimental models in Medicare and Medicaid to drive value and quality throughout the entire system; and (4) removing government burdens that impede this transformation.
And as noted by Secretary Azar, despite the Administration’s strong belief in removing regulatory burdens, it also believes that goals such as data interoperability and value-based care cannot be achieved without strong federal invention. Azar admitted: “That may sound surprising coming from an administration that deeply believes in the power of markets and competition. But the status quo is far from a competitive free market in the economic sense of the term, and healthcare is such a complex system, that facilitating a competitive, value-based marketplace is going to be disruptive to existing actors.”
Following a year in which the Administration’s healthcare policy agenda was focused almost entirely on removing regulations and repealing parts of the ACA, this call for new regulations to drive value-based reforms and interoperability should be considered nothing less than a healthcare policy “reboot” for the Trump Administration.
For providers, the ultimate impact of this reboot remains to be seen, but with critical rulemakings tied to the new MyHealthEData interoperability initiative, 21st Century Cures Act, and MACRA Quality Payment Program all set for release in the coming months, 2018 is shaping up to be another busy year in D.C. for healthcare policy.
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