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Transformation Hub

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Payment
September 10, 2019 02:50 PM

Americans 'fed up' with high healthcare costs, surprise billing, Verma says

Michael Brady
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    Emily Olsen
    CMS Administrator Seema Verma

    CMS Administrator Seema Verma on Tuesday called on hospitals to get on board with the Trump administration's transparency and value-based payment policies, warning they could face tougher times and more government insurance competition if they resist.

    Verma said the status quo is unacceptable and must change because Americans are "fed up" with high healthcare costs and surprise billing. She cautioned that these issues have led to calls for more government involvement in healthcare, which would ultimately harm hospitals' bottom lines and increase regulatory burden.

    She presented hospitals with a stark choice at an American Hospital Association meeting: embrace the Trump administration's competition- and value-based approach to healthcare reform or prepare for dwindling fee-for-service revenues and Medicare for All or a public option.

    "Our choices are clear, we can choose Medicare for All or a public option, doubling down on government and a one-size-fits-all, socialist approach, with government price setting . . . [or move] to a system of competition and value," Verma said.

    More providers are participating in Medicare's Accoutable Care Organization program under its Pathways to Success initiative, she said. She also promised to give providers the flexibility they need to smooth their transition to value-based payments.

    But providers fear they'll bear the cost of the $2.9 billion in additional savings the initiative is projected to generate over the next decade.

    Verma tried to convince the audience that the Trump administration is a trustworthy partner for healthcare reform, noting its work on the recovery audit contractor program, regulatory burden and Hospital Compare quality ratings.

    "Value-based payment under the Trump administration is the future," said Verma. "So, make no mistake — if your business model is focused merely on increasing volume rather than improving health outcomes, coordinating care and cutting waste, you will not succeed under the new paradigm."

    Tags: Payment, This Week in Healthcare, Centers for Medicare & Medicaid Services (CMS), Value-based payment, Price transparency, Regulation, Payment reform, Payment, Healthcare Reform, Transformation, Transformation Hub, Web Exclusives
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