It’s time for health insurers and health-care providers to stop lagging behind medical innovation, the head of the Department of Health and Human Services is telling the industry.
“Personalized medicine has come to life, and cell therapies are receiving FDA approval,” Alex Azar, a former drug industry chief, told the Federation of American Hospitals earlier this week. “But innovation in payment and delivery systems is simply not proceeding at the same pace,” he said.
Azar, who is speaking to America’s Health Insurance Plans March 8, noted that the shift away from fee-for-service payments to a value-based system has been going on for more than a decade, and “is still far from reaching its potential.”
“Medical science is rapidly moving towards precision treatments at the level of an individual’s genes,” Mark Fendrick, director of the University of Michigan’s Center for Value-Based Insurance Design, told me.
“Yet our ability to provide these amazing innovations is in the Stone Age. I call it Star Wars science and Flintstones delivery.”
Under Azar, the HHS is moving to push the industry forward. On March 6, Centers for Medicare & Medicaid Services Administrator Seema Verma announced at a gathering of health information technology executives in Las Vegas the MyHealthEData initiative as well as Medicare’s Blue Button 2.0 program to give patients access to their health data and share it with providers.
Verma called on health insurers to follow CMS’s lead and give patients access to their claims data in a digital format.
Azar also broached the topic of Medicare demonstration projects. The Trump administration scrapped two Obama administration demonstrations bundling payments for some procedures. But at the FAH conference, Azar said HHS wants to look at “bold measures that will fundamentally reorient how Medicare and Medicaid pay for care and create a true competitive playing field where value is rewarded handsomely.”
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