Week In Review
A lot happened in healthcare this week. Let’s discuss some of the highlights and the impact for states.
The Health Information Management Systems Society (HIMSS) had their annual conference this week in Las Vegas. Over 40,000 health IT vendors, government officials, and providers gathered to learn more about the state of play for health IT. Since the advent of the HITECH Act in 2009, this annual conference has grown in attendance and domain interest. Initially, HIMSS was more focused on technology, but over time has evolved to include several other topics. Since technology enables delivery system reform, value-based purchasing, analytics, and broader discussions on price transparency, the conference now touches on these topics, hence the large attendance.
This year, some of the speaker highlights included Jared Kushner, Senior Advisor to the President and White House Innovations Director, as well as Seema Verma, Administrator of the Centers for Medicare and Medicaid Services (CMS).
Kushner and Verma used their time to discuss the Trump Administration’s plans to improve interoperability between data and systems, something of a bugaboo for the health IT ecosystem. Verma also discussed the launch of the Blue Button 2.0 and MyHeathEData. According to Verma, the new Blue Button 2.0 “is a developer-friendly, standards-based API that enables Medicare beneficiaries to connect their claims data to secure applications, services, and research programs that they trust.” MyHealthEData is a joint initiative between the CMS, the HHS Office of the National Coordinator for Health IT (ONC), the National Institute for Health (NIH), and the Veterans Administration (VA). The goal of MyHealthEData is to reduce the challenges in place that prevent patients from easily accessing their healthcare data.
Federation of American Hospitals
Secretary of HHS, Alex Azar, delivered prepared remarks to the Federation of American Hospitals on March 5, 2018. In this speech, Secretary Azar publicly identified his top goals for his time at HHS:
- The “value-based transformation of our entire healthcare system”
- Combating the opioid epidemic
- Lowering the price of prescription drugs
- Addressing the “cost and availability of insurance, especially in the individual market”
Many industry experts have suggested that this was a way of emphasizing to the industry that value-based purchasing would continue to be a priority for HHS. Former Secretary Price had suggested that many of these initiatives led to undue provider burden and made reducing provider burden a stated goal. This redirection from the previous administration’s value-based purchasing initiatives for Medicare and Medicaid led to a skittish provider community, unclear on the direction HHS would continue to take. Azar’s speech may clarify this direction. Since many state initiatives, in and outside of Medicaid and CHIP, continue to address value-based purchasing arrangements, this confirmation from Azar should be comforting, not just to providers, but also state government officials and health plans.
America’s Health Insurance Plans (AHIP) Summit
Speaking of health plans… Commissioner of the Food and Drug Administration (FDA), Scott Gottlieb, spoke at the AHIP Health Policy Conference in Washington, D.C. on March 7, 2018 and HHS Secretary Alex Azar spoke on March 8, 2018.
Gottlieb’s prepared remarks addressed many concerns with the opacity of drug prices and the resulting consumer burden. He discussed the market-based challenges generics and biosimilars are facing. Gottlieb referred to a “rigged payment scheme” between health insurers, drug manufacturers, and pharmacy benefit managers as the primary cause for the stifling of these emerging efforts to lower drug prices.
This speech was roundly considered to be the Trump Administration’s most forceful rebuke yet of high drug costs and the impact on overall drug spending in the U.S.
Speaking to AHIP the next day, Secretary Azar told the audience that the administration will intervene with the health plans to ensure greater price transparency and a more competitive market that would benefit consumers. Azar also referred to letting the health plans continue to have more flexibility “within the law.”
The latter statement may refer to efforts, such as those in Idaho, that allow health plans to create offerings not considered legal under the Affordable Care Act (ACA). It remains to be seen how Azar expects to handle states’ efforts that are inconsistent with the ACA, so long as the ACA is still law.