HHS Secretary Alex Azar on Wednesday vowed to make value-based care models easier for providers to build and sustain, specifically praising the CMS' latest idea for direct provider contracting in Medicare.
Some providers read into the promise that HHS will ease provider self-referral restrictions that they say inhibit physicians and hospitals from building accountable care organizations.
In his speech wrapping up the American Hospital Association's Washington conference, Azar said the CMS Center for Medicare and Medicaid Innovation's proposal for direct provider contracting in Medicare and the accompanying request for information represents "the kind of fundamental rethinking of provider compensation that may be necessary to deliver value."
"The direct provider contracting proposal also reflects our interest in testing ways to reduce burdens on providers, especially those that may be impeding care coordination," Azar said.
This touches on Stark law restrictions—which ban physicians from referring Medicare or Medicaid patients to their own hospital or office—to help hospitals and physicians work through ACO models with bundled payments, according to Sean Hopkins of the New Jersey Hospital Association.
"I think some of the things that he was discussing was the opportunity to reduce the barriers for provider collaboration that go back to the Stark law that prohibits ACOs where hospitals and providers can start to share and drive cost savings," Hopkins said after the speech. "They will bring those barriers down as well."
Azar returned to the theme of pushing broad interoperability of health records as well, and the initiative to give patients access to their own data.
"We at HHS don't want to micromanage how the system gets to interoperability, but we are going to provide the right incentives to make it happen," Azar said.
Cathleen Bennett, president and CEO of the New Jersey Hospital Association, said hospitals need this if they are going to drive collaboration, and noted that so far electronic health records have required a huge amount of investment with very little payoff so far.
"You almost have a monopoly around EHR and EMR vendors and yet the systems don't talk to each other," Bennett said. "It would be interesting to see what percentage of free cash is spent investing in IT and it still hasn't reached its potential. And that's where we all want to be. Once you get there it's much easier to move into collaboration.
When it came to drug pricing—President Donald Trump's long-awaited announcement of a strategy to curb pharmaceutical costs is just two days away—Azar didn't offer anything beyond what he said in an address last week that promised the president will go "much, much further" than his 2019 budget blueprint and incorporate new negotiating tactics while ending foreign companies "free-riding off of American investment in innovation."
In one ad-libbed line, however, Azar compared his regard for drug prices to his regard for Iran.
