Medicare Administrator Takes Deregulation on the Road

“Ten minutes and focus on her remarks.” 

Those were the ground rules for my interview yesterday with Seema Verma, the administrator of the Centers for Medicare & Medicaid Services (CMS).

The topic of her remarks? Quality measurement activities that doctors and other health care providers have to follow to do business with her agency.

Not the most palpitation-producing of subjects, but definitely a headache I gather for some who have to document their submissions.

With an Oct. 30 proposal called Meaningful Measures, the agency plans to weed out some quality reporting that requires providers to document what they’ve been doing – known as process measures – in favor of health outcome measures.

Okay.  I understand why you want to trim some of these measures but just what are you going to be doing? I asked her.

“We want to know how many we have, are they really focusing on patient care, how burdensome are those measures in term of collecting them,” she responded.

We also touched on alternative payment models. Medicare wants more doctors to join them and in some cases they then won’t have to submit those quality measures.

The agency is sifting through responses from its “request for information” to the public for ideas on payment models for its innovation center to develop, Verma said. Among the topics for comment in the RFI are prescription drug models, including those that use value-based purchasing arrangements aimed at lowering costs.  

“We’re going to be putting out some potential models,” Verma told me. One will be on payment for high-cost drugs, she said.

Another will be on direct primary care, which I found out later has its own coalition. Supporters  favor a contract between a patient and a primary care provider that spells out that medical services are for an agreed-upon fee and time period. No billing of third parties. 

The agency is taking its deregulatory show on the road--been to Connecticut and Ohio. After I left, Verma and staff were off to Richmond, Va. The 10-minutes were up.

Read my full story here.

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