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5 Key Takeaways From CMS' Andy Slavitt

Laura Joszt

As the team at CMS prepares to hand the reins over to the next administration, Andy Slavitt, acting administrator of CMS, took the time to speak with Mandi Bishop, MA, CEO of Aloha Health, in the latest podcast of Managed Care Cast about what he learned in his role and what the next administration should keep in mind.
 
Here are 5 takeaways from Slavitt’s interview.
 
1. Working at CMS is not just a policy job, it’s a service job
Throughout his time working as acting administrator, Slavitt has made it a point that any time his team thinks about a policy, they also think about how it will affect the millions of Americans they serve. One example is when CMS started working on the Hospital Compare website and the tools people can use to make decisions about their care.
 
“We really said, ‘it’s not just about the policy, but how we bring the policies to the kitchen table of the American family,’” Slavitt said. How will they use these tools to choose a long-term care facility to put a parent in, what questions will they ask?
 
2. User-driven policy design
The concept of “user-drive policy design” has been something for people to rally around. The idea of it is to provide a 360-degree view of something. When considering a policy on long-term care, find out what patients think, what nurses think, and what facilities think, not just what the lobbyists think.
 
3. Being willing to hear bad news
In the process of finding out what various stakeholder groups think about policies, they had to be willing to hear complaints, Slavitt said. As part of that, CMS has set up counsels that meet with patients to say what they do and don’t like.
 
“If you can build a culture where people are willing to hear bad news and willing to hear complaints, and you can build enough external communication so people can know you’re working on these things, you’re listening to them, you’re making adjustments, and you're improving, you actually find you can get a lot more done,” he said.
 
4. What is next as the new administration sets up
A number of large changes are expected to occur as the new administration comes into the White House, but a lot is still unknown. Slavitt declined to make his own predictions of how his successors will address ongoing challenges, but said they deserve the chance to execute their own vision.
 
But he did add that as people who work for the American public, they will need to hear from the public what the challenges and priorities are.
 
“They will work for us, just as I work for you all now, and that means that they will have to hear what’s important to us,” he said.
 
5. MACRA will stand
The Medicare Access and CHIP Reauthorization Act (MACRA) has been a great example of bipartisan legislation and will continue on with the next administration. MACRA is positioned to be the next stage of Medicare, and it will impact more than the program, said Slavitt. But it could fail if it is viewed as a rigid system about score keeping.
 
Instead, the law should be used as “an opportunity to create custom and bespoke models that reimburse the way physicians think they ought to be reimbursed,” he said. 
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