CMS Head Says ACA Consumers May Drive Market Change

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By Sara Hansard

Oct. 26 — Consumers in Affordable Care Act health insurance marketplaces are in a position to drive market changes, the head of the Centers for Medicare & Medicaid Services said Oct. 26.

Speaking at a conference on alternative payment models, acting CMS administrator Andy Slavitt said that during the second ACA marketplace enrollment period for 2015 plans, more than half of consumers shopped to decide whether to pick new plans and more than a quarter did so, which is “three or four times the number that do this in employer settings.” As consumers get educated about health care, he said, they “can really drive change.”

The Health Care Payment and Action Network, a stakeholder group funded by the CMS, discussed a draft white paper aimed at creating a framework for advancing changes to the health-care payment system by improving quality and delivering care more efficiently.

Continue to Make Advances

In his remarks on payment reform, Slavitt said health-care quality and safety measurements are up and medical cost increases are at “a modest level.” However, he said, “we are just getting started. Our task now is to solidify the beginnings of these improvements and continue to make real advances.”

Care providers will need to collaborate, outcomes need to continue to improve and “consumers will need to be able to access their care in ways that make the most sense for them and keep them healthier,” Slavitt said.

The CMS has set a goal of making at least 30 percent of Medicare payments through alternative payment models in 2016 and 50 percent in 2018 to move away from fee-for-service payments that have been blamed for volume rather than value in care delivery. That means health systems will have to decide whether to invest in expensive technologies and hospital expansions or in chronic disease management and population health, Slavitt said.

Making Health-Care Data Public

The CMS is making more health-care data publicly available so that providers and others can compare quality and cost effectiveness, Slavitt said. But he cited examples of doctors who said they weren't able to see patient records from specialists, and he said patient data in electronic medical records need to be able to move with the patients.

“We continue to hear stories of those who intentionally block information from moving outside their own system,” Slavitt said. He asked organizations to sign onto the Interoperability Roadmap released Oct. 6 by the Office of the National Coordinator for Health IT by making commitments to provide information to consumers, refrain from data-blocking practices and follow interoperability standards.

Slavitt also asked conference attendees to notify the CMS if they experience information blocking by sending e-mails to “We will address these issues directly as they arise with those who are responsible,” he said.

To contact the reporter on this story: Sara Hansard in Washington at

To contact the editor responsible for this story: Janey Cohen at