Health Insurance Report™ helps you track and analyze legal, legislative, and regulatory developments affecting the health-insurance industry throughout implementation of the Affordable Care Act...
April 14 — The acting head of the CMS said April 14 that with the Affordable Care Act enhancing the health-care system, the agency's priorities should include meeting consumers' evolving needs and continuing to work with providers to improve cost and quality outcomes.
Andy Slavitt, the Centers for Medicare & Medicaid Services acting administrator, also said the CMS should change how it works to ensure smooth implementation for new programs. He spoke at a Brookings Institution event on the five-year-old health-care law.
Slavitt underscored how the law has changed the health-care system for the better. For example, the ACA has reduced the uninsured rate, contained costs and improved health-care quality, he said.
While the agency focuses on reducing the number of uninsured, it must also work on helping newly covered people, Slavitt said. He mentioned a CMS program that is intended to help the newly insured to understand their benefits, called From Coverage to Care.
Announced by the CMS in June 2014, From Coverage to Care is an ongoing consumer and provider information program to help people use new health-care benefits under the ACA.
In addition, as more consumers gain access to care, the agency's priority will be to deliver better care with a payment system that keeps people healthier, Slavitt said. He said the delivery system should be aligned to meet the primary care and chronic care management needs of this population.
Cultural change among care providers is necessary, Slavitt said, which can come down to practical decision-making. Operators of care facilities, for example, may need to ask themselves if they should invest in a new MRI machine as opposed to a population health surveillance system, he said.
In January, the CMS clarified its expectations so the agency “can achieve a better and healthier health-care system,” Slavitt said.
At that time, the Department of Health and Human Services set a goal of tying 30 percent of traditional, fee-for-service Medicare payments to quality or value through alternative payment models, such as accountable care organizations or bundled payment arrangements, by the end of 2016, and tying 50 percent of payments to these models by the end of 2018.
The payment goals signaled to providers that a “tipping point is near,” Slavitt said, adding that providers must work to offer more appropriate and higher-quality care, instead of just more care.
During a question-and-answer session, Slavitt said the HHS Health Care Payment Learning and Action Network has experienced extraordinary interest from stakeholders. The HHS launched the network to help increase the adoption of value-based payments and alternative payment models.
President Barack Obama and HHS Secretary Sylvia Mathews Burwell March 25 announced a partnership with private companies and medical trade associations to develop replacements for the fee-for-service payment. The companies will be members of the Health Care Payment Learning and Action Network. The administration developed the network to help meet the goals of changing how Medicare pays for care.
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