- Center on Health Equity and Access
- Clinical
- Health Care Cost
- Health Care Delivery
- Insurance
- Policy
- Technology
- Value-Based Care
Dr Patrick Conway Is Leaving CMS to Lead Blue Cross NC
Patrick Conway, MD, MSc, will leave his position as the deputy administrator for Innovation and Quality at CMS and the director of the Center for Medicare and Medicaid Innovation to lead Blue Cross and Blue Shield of North Carolina (Blue Cross NC).
Patrick Conway, MD, MSc, will leave his position as the deputy administrator for Innovation and Quality at CMS and the director of the Center for Medicare and Medicaid Innovation to lead Blue Cross and Blue Shield of North Carolina (Blue Cross NC).
Conway has served in CMS since 2011, when he became the chief medical officer. He will join Blue Cross NC as the president and CEO-elect on October 1, taking over for current President and CEO Brad Wilson, who is retiring.
“Blue Cross NC’s role in transforming the healthcare system in North Carolina is a model that other plans aspire to and that I want to work with the Blue Cross NC team to further improve,” Conway said in a statement. “I look forward to collaborating with Blue Cross NC employees, healthcare providers, and employers to deliver the best health outcomes and best service experience at the lowest cost for our customers.”
Conway has been heavily involved in CMS’ efforts to transition to value-based care. During a 2016 speech at the fall meeting of the National Association of Accountable Care Organizations, Conway highlighted the increased alignment he has seen between Medicare and private payers. During his tenure, CMS set out to reach a goal of having 30% of Medicare payments under alternative payment models and 85% of all Medicare fee-for-service payments in some type of value-based arrangement by the end of 2016. Both of those goals were reached nearly a full year early.
“I think we see the pace of payment reform moving quickly right now,” Conway said in an interview with The American Journal of Managed Care® at AcademyHealth’s 2016 National Health Policy Conference. “I think the shift to alternative payment models, where providers are accountable for quality and total cost of care, has moved more in the last 3 years than we’ve ever seen before.”
His biggest concern had been maintaining the pace of payment reform and scaling successes to the rest of the country. Frank Holding, Jr, chair of the Blue Cross NC board of trustees, said Conway’s experiences as both a practicing pediatrician and a leader of CMS will help the company improve the health and well-being of its customers.
“At this important time in healthcare and health insurance transformation, Dr Conway brings a unique background and perspective to our company and state,” said Wilson, who will remain as CEO for an undetermined period to ensure an effective transition. “I look forward to working with him, and introducing him and his family to the great state of North Carolina.”
Prices for care at hospital trauma centers vary across hospitals; drug shortages reached a record high during the first quarter of 2024; although 3 of the biggest makers of asthma inhalers pledged to cap out-of-pocket costs for some US patients at $35, these do not apply to daily inhalers used by the youngest kids with asthma.
Read More
Navigating Health Policy in an Election Year: Insights From Dr Dennis Scanlon
April 2nd 2024On this episode of Managed Care Cast, we're talking with Dennis Scanlon, PhD, the editor in chief of The American Journal of Accountable Care®, about prior authorization, price transparency, the impact of health policy on the upcoming election, and more.
Listen
The Biden administration recently launched the Global Health Security Strategy, a new effort to combat the spread of infectious diseases; lawmakers zeroed in on the risks of massive consolidation in health care during the first congressional hearing on the Change Healthcare hack; the FDA recently announced the recall of a pair of heart devices linked to numerous deaths and injuries.
Read More
Exploring Medicare Advantage Prior Authorization Variations
March 26th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the March 2024 issue of The American Journal of Managed Care® about their findings on variations in prior authorization use across Medicare Advantage plans.
Listen
