Congressman Price – President Trump’s nominee for HHS Secretary – has offered several clues about the future of health policy under his direction. As the politics play out and reform proposals are developed, stakeholders can and should look to the likely future leader of HHS for guidance as they solidify market strategies and refine policy priorities for 2017.
Below are ten takeaways gleaned from Congressman Price’s testimony before the Senate Finance and Senate HELP Committees, as well as the written answers to questions from Members of Congress.
1. Congressman Price supports Medicare and Medicaid reform.
“In considering Medicare, it is important to appreciate that the bipartisan Medicare Trustees have told everyone that Medicare, in less than 10 years, is going to be out of the kind of resources that will allow us as a society to keep the promise to beneficiaries of the Medicare program. My goal, if confirmed, is to work with Congress to make certain that we save and strengthen Medicare. It is irresponsible for us to do anything else.”
“State flexibility is an important component in making Medicaid more workable for patients. Every state has different demographic, budgetary, and policy concerns that shape their approach to Medicaid and Medicaid expansion. That is one of the reasons I devoted so much time to help identify creative solutions, and why I believe a one-size-fits-all approach is not working for a country as diverse as the United States.”
2. Congressman Price will encourage states to look to Indiana as a model Medicaid program.
“The Healthy Indiana Plan has long been and continues to be a national model for state-led Medicaid reforms pertaining to the low-income, able-bodied adult population. It is important that Medicaid’s design helps its members to transition successfully from the program into commercial health insurance plans, as HIP’s consumer-driven approach and underlying incentive structures encourage…I support the use of HIP’s reforms in future 1115 demonstration requests by other states.”
3. Congressman Price is committed to working with states on a variety of issues (although this does not necessarily mean making additional resources available).
“I will promise you this: Regardless of the final legislative outcome, I would work as HHS Secretary to ensure that the Medicaid program is well administered, effective, and available for eligible beneficiaries and that the States/governors are given the flexibility to pursue innovative approaches that fits the needs of their States.”
“I would work with CMS to enable states to utilize [Section 1332 State Innovation Waivers] – and other – authority provided by Congress to ensure access to high-quality, affordable health insurance.”
“Every state is unique in their specific approach to the provision of services for the population eligible to receive HCBS, and we stand ready to assist states as they develop strategies to meet their particular goals.”
“As with any program or initiative relying on states, the central question for the state is often one of funding. If confirmed, I would work to see that the Department is a helpful resource to the states with respect to these services at least by providing clarity regarding their flexibility, technical assistance and support as needed, and sharing best practices.”
4. Congressman Price supports the use of telemedicine.
“Telehealth holds great promise, particularly for rural areas experiencing physician shortages and for patients with limited mobility…If confirmed, I will certainly direct CMS to take another look at this issue to ensure we are doing everything we can to maximize beneficiary access to care with appropriate safeguards against fraud.”
“Telehealth can provide innovative means of making healthcare more flexible and patient-centric. Innovation within the telehealth space could help to expand access within rural and underserved areas. If confirmed, I look forward to continued discussions on telehealth, including on the best means to offer patients increased access, greater control and more choices that fit their medical needs.”
5. Congressman Price will support – and likely encourage – further efforts by CMS to reduce the provider burden associated with implementation of the Medicare Access and CHIP Reauthorization Act (MACRA).
“The recent CMS MACRA final rule approached the first year of the Quality Payment Program as a transition year, and took steps to address physician concerns regarding the burdens associated with program participation. I think significant challenges remain with respect to provider burden, and if confirmed, I plan to direct the CMS Administrator to ensure that the program is structured to achieve its quality and budgetary goals, while ensuring that patients and the providers who care for them are at the center of our reform efforts.”
6. If Congress chooses to keep and fund CMMI, Congressman Price will use the office to pursue provider-led innovation that reduces cost and improves care.
“CMMI is a program providing significant opportunity for testing new models for health care financing and delivery. If confirmed, as HHS Secretary, and if the Innovation Center remains funded, I will ask CMS to pursue models that will lower health care costs and improve quality for Medicare and Medicaid beneficiaries.”
“What we ought to do is allow for all sorts of innovation. Not just in this area. There are things that haven’t been thought up yet that would actually improve health care delivery in our country and we ought to be incentivizing that kind of innovation. And in finding our way to those innovations, we ought to remember we are not talking about science experiments in a lab or computer simulation, but about experiments involving real patients’ lives.”
7. Congressman Price supports CMS’s largest value-based care initiatives but will likely advocate for programmatic changes.
“As a doctor, I appreciate the goal behind the creation of the ACO model: better patient care. As a legislator, I would agree their successes have been modest to date, and there are some challenges they face as well. ACOs are a tool in the toolbox to help ensure high quality, low cost health care for beneficiaries. They are not a silver bullet to all of our country’s delivery system challenges. If confirmed, I plan to work with the CMS Administrator to ensure that we learn from ACOs’ successes and challenges to date as we chart the path forward.”
“For certain populations, bundled payments make a lot of sense. And they can often lead to both better health outcomes and reduced costs. But it is important we not get fixated on one of those two outcomes. That is, I support making certain that we deliver care in a cost-effective manner but we absolutely must not do things that harm the quality of care being provided to patients.”
Information gleaned from the confirmation process – as well as Congressman Price’s legislative record – enables stakeholders to identify key themes and issues that are likely to be important to the future HHS Secretary. This information should be used for planning political and policy-based campaigns, and to build coalitions to drive transformation.
Contact Sirona Strategies if you feel your business could benefit from a deeper understanding of health care policy or you want to discuss strategies for working with the Executive Branch to achieve your health care objectives.