Verma's Vision for CMS: Going Digital and Less Regulatory Burden

Laura Joszt

CMS is focusing on patient empowerment and unburdening physicians, said CMS Administrator Seema Verma during her keynote speech at the Office of the National Coordinator for Health Information Technology’s Annual Meeting.

In her roles prior to joining CMS, Verma spent a lot of time on the front lines with patients and providers, understanding the challenges people face on a day-to-day basis trying to deliver quality healthcare. That experience and a listening tour across the United States have helped form the basis for CMS’ new foundation under the Trump administration.

“So many of us have used the healthcare system and can attest, at times, that it’s confusing,” Verma said.

One of the initiatives that CMS is working on is as-yet unnamed, although Verma is partial to “Digital Seniors.” More and more people are entering Medicare and are comfortable with technology, but CMS is still mailing out paper handbooks. The paper format may work for some, but not for all.

“We need to think about the new generation of beneficiaries, and how we interact with them and how we give them information,” she said.

Another initiative, called “Patients Over Paperwork,” addresses the regulatory burden facing physicians that impedes patient care. While there are good reasons for regulation—such as quality, program integrity, value, and safety—at some point, too much regulation can become suffocating, Verma said.

Traveling across the country and speaking to providers, CMS has heard that the regulations and the paperwork are taking time away from patients and placing too much of a burden on physicians.

“Across the board we’re taking a hard look at the regulations we’re putting out,” Verma said.

As part of its listening tour across the United States, CMS also heard constantly about the issues around electronic medical records (EMRs) and interoperability. The problem, she said, is that many of the systems physicians are working with were not built for them and how they deliver care. Instead, these EMRs were built as billing systems.

“EMRs are a good thing,” Verma said, but the challenge with them is “a matter of how they were designed.”

Fixing the issues with EMRs and interoperability will be beneficial in addressing drug pricing. The emerging models of how to pay for new, expensive drugs, such as outcomes-based pricing, require data and information and sharing that through interoperability.

Verma also relayed her own personal experience with the health system and the challenges with interoperability, which occurred when her husband went into cardiac arrest while at the airport. He and their children had been waiting for a layover, so they were not in their home state. Verma’s husband was taken to the local hospital, went through a number of tests before a diagnosis was made and he was cared for. However, at the time of discharge, when he was going to return home for care in their home state, the Vermas ran into trouble getting the list of tests he had already gone through.

What Verma ultimately left the hospital with was a document of what the final diagnosis was, and a CD-ROM, both of which were of little help.

This story is not uncommon in Medicare, where beneficiaries are not always in 1 place. They may be snowbirds and spend half the year in warmer weather; they may have caregivers in another state; they may visit family for extended periods of time.

“People need to be able to have their information with them,” Verma said.
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