ICYMI: Notes from the field for February 2019

DATE: March 4, 2019

As the year rolls on, February’s news cycle featured a lot of dispatches from HIMSS, along with a few policy updates from CMS. Here’s what caught our attention—what’s been on your mind?


Policy Played a Big Role at HIMSS19

  • CMS Administrator Seema Verma at #HIMSS19 discussed new transparency requirements for Medicare program participants. This is the “strongest lever” CMS has to ensure that free-flowing data supports better patient safety, improved outcomes, and lower overall costs. How will this impact those participating in MIPS?
  • Fundamental change in healthcare is needed and everyone knows it. A 28-year veteran of HIMSS believes that there’s new opportunity to affect that change: “…[W]ith the releases of the proposed CMS and ONC rules we’ve reached an inflection point—an important one.”
  • In his remarks at HIMMS19 HHS Secretary Alex Azar declared: “We cannot build a value-based healthcare system without advanced health IT, and we cannot advance health IT without your bold ideas and creative thinking.” A call to action for all healthcare industry players.


New from CMS

  • The Center for Medicare and Medicaid Innovation introduced the Emergency Triage, Treat, and Transport (ET3) Model in February, 2019. This voluntary program aims to provide greater flexibility to ambulance care teams caring for Medicare beneficiaries following a 911 call.
  • Highlights from a recently released CMS expenditures report: Average annual spending growth in Medicare is expected to surpass Medicaid and private health insurance from 2018 to 2027, while the insured share of the population is expected to stay at about 90% through 2027.
  • Effective interoperability has yet to become a normal part of healthcare—but hope is on the horizon. CMS discussed its efforts to further achieve interoperability, as well as highlight its vision for interoperability in the future.
  • Medicare is working to expand its value-based insurance design model, and announced plans to create a new drug model—which they hope can reduce drug spending. CMS also released an evaluation of the first-year results for the MA VBID program, which recently expanded to 18 states. Most plan data wasn’t complete to create a full impact report, so it’s unclear how effective the program has been.


Future Outlook and Rising Cost of Healthcare

  • The Health Care Cost Institute (HCCI) 2017 report looks at claims data for about 40 million individuals on employer-sponsored health plans. Conclusion: Healthcare spending has been rising over the past few years. Healthcare policymakers can use this information to propose new methods for caring for patients with chronic illness or other costly health needs.
  • New projections from CMS report that hospital care spending is expected to accelerate over the coming 10 years as Medicare enrollments surge, more states expand Medicaid eligibility, and prices increase.
  • A recent survey highlights ways payers can incentivize providers to enter collaborative projects. The VBC train may be slow to leave the station but there’s no turning back on the growing use of data sharing to drive care. Success in value-based arrangements requires payers and providers to work closely together, share data and benchmark outcomes and spending.
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