Health and Science

Medicare chief says it’s time health care caught up to other industries to benefit consumers

Key Points
  • The head of the Centers for Medicare and Medicaid Services said consumers need greater transparency about health-care prices up front.
  • Patients also should have easier access to their records and health data once they have received care.
  • Health officials will take comments on the proposed data access rules over the next two months.
CMS's Seema Verma: It's time health care caught up to other industries

The head of the Centers for Medicare and Medicaid Services said Monday it's time that health care catches up with other industries when it comes to providing consumers greater transparency about prices up front and easier access to their records and health data once they have received care.

"We know that any other place in the economy you can know what things are going cost. Somehow in health care it's a big mystery," said CMS administrator Seema Verma, in an exclusive interview at the World Health Care Congress in Washington, D.C., where she was the keynote speaker.

"We are starting (with) asking hospitals to post their prices on line. We have a long way to go," she said.

While the agency spent much of 2017 focusing on the administration's efforts to repeal Obamacare, this past month CMS issued a series of new proposals aimed at promoting greater interoperability of digital health-care records. They include forcing hospitals to post their prices online, and pushing them to transfer patients' discharge records to their doctors electronically, even if the doctors are not part of the same health system.

Doctors who treat Medicare patients are already required to write prescriptions electronically. CMS now wants them to also make it easier for patients to access those records digitally.

"Imagine a world if you're collecting all of your health-care data from the time of birth all the way through your life," Verma said. "We want to get to a point where patients have all of their health-care information in one place."

Health officials will take comments from industry stakeholders and the public on the proposed data access rules over the next two months.

The comment period closed last week on the administration's proposals to allow health insurers to sell short-term plans that would not have to comply with Obamacare coverage regulations.

The proposal met with a record number of comments, with a number of health insurance groups expressing concern that the short-term plans will undermine the health exchanges by siphoning off younger, healthier consumers who will no longer face a penalty if they enroll in non-compliant plans in 2019.

Verma would not say whether the administration will roll out the short-term plans in time for open enrollment on the health exchanges this fall.

Also, she categorically rejects critics' arguments that the administration's actions undermined the Obamacare marketplaces as they were beginning to stabilize in the last year.

"We want to move as quickly as possible, but we have to go through that process of considering (the comments) we've received," Verma explained. "The bottom line is that insurance premiums have skyrocketed and there's a number of people that just can't afford to pay."

President Donald Trump is expected to unveil new proposals to combat rising drug prices soon. The administration's 2019 budget outline includes a proposal to give Medicare Part D plans for seniors more power to negotiate lower prices from manufacturers, and it initiates a pilot program that would allow state Medicaid programs to test drug formularies aimed getting more competitive prices.

Massachusetts has a Medicaid waiver requesting the ability to administer its own formulary in order to negotiate pricing beyond the current discount for the safety net program. So far, the administration has not indicated whether it plans to grant the waiver.

While declining to address the Bay State's request specifically, Verma outlined what she considers key issues for approving state requests.

"Generally (when) we look at every waiver ... we want to get states where they want to go; achieve objectives they want to achieve," she explained, but added that plan savings are also an important factor. "We look at budget neutrality — proposals won't cost federal government anymore than the federal plan."

Verma would not commit to a timeline for the new proposals, but says we should expect to hear a lot more changes from her agency over the coming months.