In a keynote address at the 2018 National Health Policy Conference of America’s Health Insurance Plans (AHIP) in Washington, DC, HHS Secretary Alex Azar asked his audience to consider 4 areas that he said are key to “accelerating value-based transformation, and creating a true market for healthcare” through means of some sort of federal intervention that puts patients in control of their own health records.
The speech was almost exactly the same as one delivered earlier in the week at the Federation of American Hospitals meeting.
Azar described 4 areas of emphasis:
- Giving consumers greater control over health information through interoperable and accessible health information technology
- Encouraging transparency from payers and providers
- Using experimental models in Medicare and Medicaid to drive value and quality throughout the entire system
- Removing government burdens
“The key theme uniting these 4 priorities is the recognition that value is not accurately determined by arbitrary authorities or central planners,” he said.
The changes will allow patients to determine value, and that the changes “will require some degree of federal intervention—perhaps even an uncomfortable degree,” he said.
“That may sound surprising coming from an administration that deeply believes in the power of markets and competition. But the status quo is far from a competitive free market in the economic sense of the term, and healthcare is such a complex system, that facilitating a competitive, value-based marketplace is going to be disruptive to existing actors.”
HHS is “more interested in setting out simple goals: Patients ought to have control of their records in a useful format, period. When they arrive at a new provider, they should have a way of bringing their records, period. That’s interoperability—the what, not the how.”
Azar also talked about developments announced Tuesday
by CMS Administrator Seema Verma and Jared Kushner of the White House Office of American Innovation.
Medicare’s system of providing claims data via printed PDFs, called Blue Button, will be renamed Blue Button 2.0 and will use open application program interface, more commonly referred to as APIs, to give private tech developers access to data in a form that can be built into their apps—similiar to Yelp, Amazon, or OpenTable—so that patients could have information at their fingertips at any provider visit.
He said more than 100 tech companies have already signed up.
Kushner also announced MyHealthEData, which Azar said "will take a broader view of the goal we’re working toward within the Medicare program by Blue Button 2.0: How can we help private payers and providers put patients in charge of their data?"
Azar said CMS' Meaningful Use incentives will be overhauled to focus on encouraging interoperability.
"Data sharing encouraged by CMS, for instance, could enable providers to avoid duplicative testing, saving money and sparing the patient unnecessary inconvenience," he said.
Regarding price transparency, Azar said patients "ought to have the right to know what a healthcare service will cost—and what it will really cost—before you get that service."
He said the price transparency problem is not limited to payers or providers, but to prescription drugs as well, although his speech did not included any announcements about drug pricing. He reiterted a statement made earlier in the week praising UnitedHealthcare for announcing
that it will pass drug manufacturer rebates to consumers. UnitedHealthcare owns OptumRX, a pharmacy benefits manager.
He also said the admistration will look to using Medicare and Medicaid to drive value-based transformation and told the audience his department will listen and act on comments sent to CMS.
"We will also bear in mind whether new burdens created by models, or the scale they require for viability, may be driving consolidation in the healthcare market. As a matter of principle, we want to move to a system where we can be agnostic about ownership structures, a system that will allow independent providers to group together to drive innovation, quality, and competition," he said.
Azar also said HHS will look at burdens placed on insurers.